Search:
		ACF Home   |   Services   |   Working with ACF   |   Policy/Planning   |   About ACF   |   ACF News   |   HHS Home

	Questions?  |  Privacy  |  Site Index  |  Contact Us  |  Download Reader™  |  Print

Attachment A

Annual Report on TANF Programs Under 45 CFR 265.9(b)

(1) The State's definition of each work activity.

45 CFR 261.30 encompasses the 12 categories of work activities listed in Section 407(d) of the Social Security Act for purposes of determining the State's required minimum work participation rate(s). Each State defines the activities that fall under each of these 12 categories and provides them to us. This item is for that purpose. Therefore, your definitions should include the kinds of work activities that apply to each of the 12 categories. For example, what activities comprise "job skills training directly related to employment" in your State?

The following list is an overview of federally countable work activities. Some restrictions apply regarding the length of time allowed in certain activities, and who may participate in them. Detailed information can be found in the Work First manual section 118, V. (See the Division of Social Services Online Work First Manual at http://info.dhhs.state.nc.us/olm/manuals/dss/csm-95/man/index.htm .)

• Unsubsidized employment – an unlimited, paid work activity. Employment may occur in any for-profit, non-profit, public, or private setting. Wages earned in this activity are not subsidized.

• Work Experience – an unpaid work activity (subject to the Fair Labor Standards Act). Work Experience may occur at any non-profit, public, for-profit, or private organization. Participation in this activity may provide an intensive training experience, enhance participants’ employability, offer exploration in a new career, or strengthen their existing work history. The State submitted to the U. S. Department of Agriculture (USDA) a Simplified Food Stamp Plan to seek permission to count the value of a family’s food stamps in calculating the maximum number of hours of work experience participation. USDA approved our plan.

• On-the-job training – a subsidized work activity. Each individual county based on the circumstances locally will determine the amount of subsidy. On-the-job training may occur in any non-profit, for profit, public or private setting. Participation in this activity offers the opportunity to learn a new trade, in a supportive environment, while transitioning into a regular, unsubsidized employee status.

• Job Search and Job Readiness – provides skills to enhance overall employability. Participation in this activity includes, but is not limited to, exposure to job-seeking skills, improved job retention, conflict management, substance abuse counseling/treatment, goal-setting, and household budgeting.

• Community Service – an unpaid work activity. Community service is generally performed in a government or non-profit agency. The length and type of community service is determined locally with required hours set by the court.

• Vocational educational training – a short-term educational activity that leads to preparation for a specific vocation. Likely providers of vocational educational training include, but are not limited to: Community Colleges, post secondary institutions, and non-profit organizations. Participation and support in graduate and post-graduate programs is not counted.

• Providing childcare for Work First participants in community service – an unpaid work activity. Providing childcare to individuals in Community Service must adhere to established rules and statutes. Participation in this activity provides an excellent venue for individuals desiring to open their own, for-profit, child care operation.

• Completing high school or a GED – a traditional educational activity that leads to a high school diploma or its equivalent.

• Subsidized employment – an employment opportunity in public, private, for-profit, or not-for-profit situations where the participant’s wage is not paid entirely by the employer. The employment may be subsidized from any source. Counties may include wage supplementation in their plan.

• Job skills training directly related to employment.

• Education directly related to employment.
Optional items and information specific to North Carolina are discussed below:

• Work Experience - USDA approved a simplified food stamp plan to count the value of a family's food stamp benefits in calculating the maximum number of hours of work experience participation.

• North Carolina does not require community service employment within two months of receiving assistance.

(2) A description of the transitional services provided to families no longer receiving assistance due to employment.

Indicate the kinds of help provided to working families that received, but no longer receive, "assistance" as defined in 45 CFR 260.31.

North Carolina has been very successful in helping families move from cash assistance to work. However, helping families stay employed and be successful is an important issue with which all counties are dealing. All counties are encouraged to provide in their local plan for provision of a variety of services for families with income at or below 200% of the poverty level that have a child who meets the same requirements as for Work First Family Assistance.

These services include, but are not limited to, job retention services, child and family enrichment services, support services, employment services, and preventive services. Counties describe in their local block grant plans whether they will provide such services and if so, who will be served and what types of services they will provide. Services may be varied, including but not limited to, transportation, child care, job retention bonuses, case management, follow-up, mentoring, after school learning programs, parenting programs, literacy programs, and post- employment skills training. Providing retention and other family services is one area in which many counties are reaching out successfully for community assistance.

Families who have exhausted their 24 or 60-month time limit are eligible for these services, provided all other eligibility criteria are met.

(3) A description of how a State will reduce the amount of assistance payable to a family when an individual refuses to engage in work without good cause pursuant to 45 CFR 261.14 of this chapter.

Parents who fail without good cause, to participate in work or work activities, comply with the terms and conditions of their Mutual Responsibility Agreement, quit a job without good cause, are fired from a job with cause, refuse a bona fide offer of employment, or fail to follow-up on a job referral, will incur a sanction that will make the entire family ineligible for a Work First Family payment for one month or until compliance, whichever is later.

• Families in sanction status will be apprised of available community resources, including assistance through the county department of social services. Agency staff trained in indicators of child abuse and neglect are expected to make reports as appropriate.

• Good cause is defined as:

- A significant family crisis or change;
- Illness of the caretaker or child, including participation in substance abuse treatment or medical appointment;
- Civil leave, including jury duty, or a required court appearance; and
- Any other reason deemed sufficient by the county director or designee.

(4) The average monthly number of payments for child care services made by the State through the use of disregards, by the following types of child care providers:

(i) Licensed/regulated in home child care;

(ii) Licensed/regulated family child care;

(iii) Licensed/regulated group home child care;

(iv) Licensed/regulated center based child care;

(v) Legally operating (i.e., no license category available in State or locality) in home child care provided by a non-relative;

(vi) Legally operating (i.e., no license category available in State or locality) in home child care provided by a relative;

(vii) Legally operating (i.e., no license category available in State or locality) family child care provided by a non-relative;

(viii) Legally operating (i.e., no license category available in State or locality)
family child care provided by a relative;

(ix) Legally operating (i.e., no license category available in State or locality)
group child care provided by a non-relative;

(x) Legally operating (i.e., no license category available in State or locality)
group child care provided by a relative; and

(xi) Legally operated (i.e., no license category available in State or locality)
center based child care.

The State of North Carolina does not utilize disregards to make child care payments.

(5) If the State has adopted the Family Violence Option and wants Federal recognition of its good cause domestic violence waivers under 45 CFR 260.50-58, then provide (a) a description of the strategies and procedures in place to ensure that victims of domestic violence receive appropriate alternative services and (b) an aggregate figure for the total number of good cause domestic waivers granted.

(a) Violence in the family is a substantial barrier to self-sufficiency for many people, including some Work First participants. Family violence is defined as verbal, sexual, emotional, psychological and/or physical abuse between or among family members or intimate partners. Recognizing the impact that violence can have upon individuals and families, workers must assure that all individuals seeking assistance are given the opportunity and services necessary to address the violence.

North Carolina adopted the Family Violence Option to assist those participants who are or have been victims of family violence by providing the necessary tools to address the issues related to the abuse. For some participants, the Option provides an opportunity for a waiver of one or more Work First requirements. For all participants, however, the Option seeks to heighten awareness of family violence and provides the means and impetus to develop appropriate methods for dealing with it. By being more knowledgeable of the issue of family violence, workers can make more informed referrals and offer services that will help individuals deal with the violence in their lives.

Adults seeking Work First assistance, including payees in child only cases and teen heads of household are given information about family violence and the services available to deal with the issue. Should the adult self-disclose or the worker find evidence of family violence, the worker discusses with the individual the services available to deal with the issue and makes any appropriate referrals.

All Work First participants are notified of the potential to request a waiver of some or all of the Work First requirements. If, at any time, a participant discloses being a victim of family violence, the participant is referred to an individual trained in family violence. This individual will conduct a screening and/or an assessment of the participant's barriers to obtaining and/or keeping a job and meeting other Work First requirements.

Counties must develop a plan for addressing how the Option will be implemented and operated locally. Each county must designate an individual(s) within DSS or get the assistance of an outside agency to conduct screening and/or assessments. The individual conducting the assessment must be trained in family violence. Every effort must be made to train new employees within 90 days of employment.

(b) A total of twenty-seven (27) individuals were granted good cause domestic violence waivers in FFY 2004.

Detailed information concerning the Family Violence Option can be found in the North Carolina Work First Manual Section 104D. (See the Division of Social Services Online Work First Manual at http://info.dhhs.state.nc.us/olm/manuals/dss/csm-95/man/index.htm .)
(6) A description of any non-recurrent, short-term benefits (as defined in 45 CFR 260.31(b)(1)) provided, including:

(i) The eligibility criteria associated with such benefits, including any restrictions on the amount, duration, or frequency of payments;

(ii) Any policies that limit such payments to families that are eligible for TANF assistance or that have the effect of delaying or suspending a family's eligibility for assistance; and

(iii) Any procedures or activities developed under the TANF program to ensure that individuals diverted from assistance receive information about, referrals to, or access to other program benefits (such as Medicaid and food stamps) that might help them make the transition from welfare to work.

Benefit Diversion

Work First Diversion Assistance is available to families in lieu of traditional cash assistance when they need short-term help to become or remain self-sufficient. Diversion Assistance should not be confused with emergency assistance. Diversion Assistance is intended to assist with parents’ needs that help them stay employed or be self-sufficient through other income sources, get through a temporary lay-off, pay household expenses until the first pay check, or help two-parent families with three months cash assistance before pay-after-performance. It is not designed just to assist with families’ sporadic emergency needs such as a utility cut-off notice or eviction notice.

To be eligible to receive Diversion Assistance, families must meet the same income and asset limits as families that qualify for Work First cash assistance. However, the amount of cash payment provided is not based on the family’s income, but rather on the family’s need. Benefits may include a cash payment of up to three months of cash assistance, employment services, Medicaid, childcare, and Food Stamp benefits. The family does not have to repay Diversion Assistance. The family makes the final decision about whether to accept Diversion Assistance in lieu of ongoing Work First cash assistance.

Diversion Assistance can be received only once in a 12-month period and does not trigger the two-year Work First time limit or the five-year federal lifetime limit on benefits. Recipients of Diversion Assistance are not required to participate in the Work First employment program. These families are not considered Work First participants, and are not considered in calculating the State’s participation rate.

Under certain circumstances, a one-time, short-term benefit package is more appropriate in meeting the needs of Work First applicants than becoming a Work First recipient. Diversion Assistance may be provided when families are in need of short-term assistance to enable them to get or keep a job or access other financial assistance that will help meet their needs. In these circumstances, Work First Diversion may provide:

1. A one-time, lump sum payment not to exceed three months of Work First benefits (the payment is not income-based, but is need-based up to a maximum of three months of cash assistance for the family size);

2. Medicaid and Food Stamps for the months in the Diversion period;

3. Employment services;

4. Eligibility for child care; and

5. Referrals to child support and other potential resources.

In order to be eligible for Diversion Assistance, families must meet the same eligibility requirements that they must meet for Work First cash assistance, including the income and asset limits. Families that receive Diversion Assistance do not have to repay the assistance received.

Families who have exhausted their 24 or 60 month time limit are eligible for Benefit Diversion, provided all other eligibility criteria are met.

Emergency Assistance

Counties must use their Work First block grant funds to provide emergency assistance to families in accordance with their local plan. Counties must define the eligibility criteria, who is eligible, and the types of emergencies that will be covered. This assistance is designed to assist with families’ sporadic emergency needs, such as a utility cut-off or an eviction notice. Emergency assistance is not designed specifically to help families move to self-sufficiency, although, use of this assistance could help a family’s progress toward that goal.

Counties will comply with federal requirements. Emergency assistance does not trigger the 24 or 60-month time limit, nor will families receiving emergency assistance be required to participate in the work program. Also, families who have exhausted their 24 or 60-month time limit are eligible for Emergency Assistance, provided all other eligibility criteria are met. These families are not included in calculating the State’s participation rates.
Families that meet the following criteria are eligible for emergency assistance. Counties are allowed to define and describe in their plans local eligibility criteria that are no more liberal than the following guidelines:

• The family must have a child who lives with a relative as defined for Work First Family Assistance and meets the age limit for Work First Family Assistance.

• Total income must be at or below 200% of poverty.

• Family members must meet the same citizenship requirements as for Work First Family Assistance.

Employment Services for Low-Income Families

Work First services described in the policy manual may be provided to any family with income at or below 200% of the federal poverty level, provided there is still a child in the household who meets the age, kinship and citizenship/alienage rules. All counties must decide whether they will provide services to such families. Therefore, this policy applies only to counties that have decided to provide these services and have submitted a local plan indicating the decision.

Countable income is the same as for Work First Family Assistance. Count the income of the family members as you would for Work First cash assistance recipients. Compare the gross total family income to the income shown by family size. You may accept the family's statement of the family's income unless it is questionable. If in doubt, request appropriate verification.

Complete and maintain the eligibility worksheet in a case file, to document the family's eligibility for employment-related services, and document the specific services provided.
The maximum authorization period is 12 months, but the case can be authorized for less than 12 months.

These services are designed to:

• Support job retention and advancement;

• Strengthen the family;

• Promote the healthy development of children and parents; and

• Encourage the formation of two-parent families.

The family is required to report all changes in income for the purpose of determining continuing eligibility.

Services may be provided to enable families to participate in a wide range of activities that will prepare them to seek and retain employment or enrich their family's life, including, but not limited to:

• Short Term Housing;
• Education (ABE, HS, GED & ESL);
• Job Search;
• Skills Training;
• On-the-Job Training;
• Job Readiness;
• Child Enrichment Activities;
• Various Counseling Activities;
• Parenting Skills;
• Transportation;
• Child Care;
• Work-related Expenses;
• Case Management; and
• Child and Family Enrichment.

Employment Services for Non-Custodial Parents

Counties may provide Work-Related Services to the non-custodial parents of children in a Work First family. The non-custodial parent's gross monthly income must be at or below 200% of federal poverty. The non-custodial parent must be a U. S. citizen or eligible alien as defined in Section 111. This policy applies only to counties that have decided to provide these services and have submitted a local plan indicating the decision. The purpose of these services is to increase the non-custodial parent's ability to pay child support and assist the parent with obtaining and maintaining employment.
The maximum authorization period is 12 months, but the case can be authorized for less than 12 months.

Countable income is the same as for Work First cash assistance.

Services may be provided to enable non-custodial parents to participate in a wide range of activities that will prepare them to seek and retain employment, including, but not limited to:

• Employment;
• Education (ABE, HS, GED, ESL);
• Job Search;
• Skills Training;
• On-the-Job Training;
• Job Readiness
• Various Counseling Activities;
• Parenting Skills;
• Transportation;
• Child Care;
• Work-related Expenses; and
• Case Management.

Detailed information concerning non-recurrent, short-term benefits (Diversion Assistance, Emergency Assistance, Employment Services for Low-Income Families (below 200 percent of poverty), and Employment Services for Non-Custodial Parents) can be found in the Work First Manual Section 102. (See the Division of Social Services Online Work First Manual at http://info.dhhs.state.nc.us/olm/manuals/dss/csm-95/man/index.htm .)

(7) A description of the grievance procedures the State has established and is maintaining to resolve displacement complaints, pursuant to section 407(f)(3) of the Social Security Act. This description must include the name of the State agency with the lead responsibility for administering this provision and explanations of how the State has notified the public about these procedures and how an individual can register a complaint.
TANF funds may not be used to contract with, or provide job placement vouchers to, public and private employment agencies. Funds may not be used to subsidize a job when a person has been laid off from the same (or substantially equivalent) job, or if an employer fired or laid off a regular employee to fill the job with a subsidized Work First participant.

Individuals will not be referred for, or placed on, a job where any regular employee has been laid off from the same job or an equivalent job; or an employer has terminated or otherwise displaced and employee or employees in order to hire a Work First participant. Employees who believe that they have been displaced solely so the employer may hire a Work First participant may file a grievance. Work First participants have the same rights under federal, State, or local laws that are applicable to non-Work First employees in the same or similar situations.

The Department of Health and Human Services has the lead responsibility for administering these provisions. These provisions were made available for public view and comment through our DSS web site. See the Division of Social Services Online Publications (TANF State Plan) at http://www.dhhs.state.nc.us/dss/publications/index.htm .
(8) A summary of State programs and activities directed at the third and fourth statutory purposes of TANF (as specified at 45 CFR 260.20(c) and (d) of this chapter).

a. Summarize below, the State programs and activities directed at preventing and reducing the incidence of out-of-wedlock pregnancies and establishing annual numerical goals for preventing and reducing the incidence of these pregnancies (TANF purpose 3):

Teen Pregnancy Prevention and Reduction of Out-of-Wedlock Births

The North Carolina Division of Public Health, in collaboration with local program administrators, the Adolescent Pregnancy Prevention Coalition of North Carolina, and other organizations utilized allotted TANF funds to establish guidelines for the administration of funds for teen pregnancy and parenting programs. Funds could be used to fund coalition building and partnership development at the local level. Grants were targeted to counties with the highest teen pregnancy rates, increasingly higher teen pregnancy rates, high rates within demographic subgroups, or greatest need for parenting programs. All programs were encouraged to implement best practice models.

Teen Pregnancy Prevention Initiatives (TPPI), housed in the Division of Public Health, provides funding for local health departments, social services departments, school systems, and other community-based agencies to work with adolescents to prevent pregnancy among target populations. These agencies use “best practice models” in group settings. Techniques may include abstinence and life skills education, youth development, parent workshops, counseling and referral, community awareness efforts, and male involvement. Topics include decision making, entrepreneurial leadership, information about specific areas of concern such as sexual coercion, statutory rape laws, and/or service learning.

b. Summarize below, the State programs and activities directed at encouraging the formation and maintenance of two-parent families (TANF purpose 4):

Responsible Fatherhood Initiative

TANF funds under this initiative were used to develop and/or support responsible parenting programs targeted at young-adult males. Funds were also targeted to counties with the highest needs as determined by the North Carolina Division of Public Health. Evaluation of the effectiveness of this initiative was combined with the evaluation of the pregnancy prevention and responsible parenting activities.

(9) An estimate of the total number of individuals who have participated in subsidized employment under §261.30(b) or (c) of this chapter.

A total of 298 individuals in 41 North Carolina counties participated in subsidized employment under §261.30(b) or (c) during Federal Fiscal Year 2004. The average monthly number of participants in subsidized employment was 75.

Attachment B

Annual Report on State Maintenance-of-Effort Programs: ACF-204

State: North Carolina      Fiscal Year: 2004

Date Submitted: December 17, 2004

Provide the following information for EACH PROGRAM for which the State claims MOE expenditures.

1. Name of Benefit or Service Program: Basic Assistance

2. Description of the Major Program Benefits, Services, and Activities: North Carolina’s Cash Assistance component of the Work First Program.

For a complete description see North Carolina’s Work First State Plan.

3. Purpose(s) of Benefit or Service Program:

The State uses Basic Assistance as a Benefit Program component to meet the statutory and regulatory TANF purposes of providing assistance to needy families so that children may be cared for in their own homes or in the homes of relatives; and to end the dependence of needy parents on government benefits by promoting job preparation, work and marriage.

4. Program Type. (Check one)

_X_ This Program is operated under the TANF program.

____ This Program is a separate State program.

5. Description of Work Activities in the SSP-MOE program (I.e., Complete only if this program is a separate State program):

N/A

6. Total State Expenditures for the Program for the Fiscal Year: $ 22,821,408

7. Total State Expenditures Claimed as MOE under the Program for the Fiscal Year: $ 22,821,408

8. Total Number of Families Served under the Program with MOE Funds: 8,342
This number includes an average monthly number of 194 Benefit Diversion cases. (Note: this is an estimated number based on the relative percentage of MOE expenditures applied to unduplicated case counts.)

This last figure represents (check one):

_X_ The average monthly total for the fiscal year.

___ The total served over the fiscal year.

9. Eligibility Criteria for Receiving MOE-funded Benefits or Services under the Program:
Maintenance of Efforts funds are used primarily to provide assistance to children. Biological or adoptive parents and step-parents may apply for assistance for a child and must be included in the payment for the family, unless they are disqualified from the program. Children are eligible for benefits through age 17. Children age 18, if in high school and expected to graduate by age 19, can receive through the month they turn 19 or graduate from high school, whichever occurs first. In order for non-custodial parents of Work First children, former Work First families, and other families with children to receive appropriate services, the family’s income and resources must meet the standards contained in the Eligibility Requirements of the TANF State Plan for North Carolina.

10. Prior Program Authorization: Was this program authorized and allowable under prior law (i.e., as defined at §260.30)? (check one)

Yes _X_ No ___

11. Total Program Expenditures in FY 1995.
(NOTE: provide only if the response on to question 10 is No.)

This certifies that all families for which the State claims MOE expenditures for the fiscal year meet the State's criteria for "eligible families."

SIGNATURE:
NAME: Carmen Hooker Odom
TITLE: Secretary, North Carolina DHHS
Approved OMB No. 0970-0199 Form ACF 204, expires 6/30/2002.

Attachment B

Annual Report on State Maintenance-of-Effort Programs: ACF-204

State: North Carolina      Fiscal Year: 2004

Date Submitted: December 17, 2004

Provide the following information for EACH PROGRAM for which the State claims MOE expenditures.

1. Name of Benefit or Service Program: Basic Assistance Housing

2. Description of the Major Program Benefits, Services, and Activities:

Rental or mortgage subsidies that meet the federal definition of assistance (See Section 102 III. B. of the Work First Manual). In general terms, subsidy payments that are provided for more than 4 months. Housing subsidies are funded solely with MOE funds.

3. Purpose(s) of Benefit or Service Program:

The State uses Basic Assistance Housing as a Benefit Program component to meet the statutory and regulatory TANF purpose of providing assistance to needy families so that children may be cared for in their own homes or in the homes of relatives.

4. Program Type. (Check one)

_X_ This Program is operated under the TANF program.

___ This Program is a separate State program.

5. Description of Work Activities in the SSP-MOE program (I.e., Complete only if this program is a separate State program):

6. Total State Expenditures for the Program for the Fiscal Year: $ 0

7. Total State Expenditures Claimed as MOE under the Program for the Fiscal Year: $ 0

8. Total Number of Families Served under the Program with MOE Funds: 0 (Note: This program was discontinued as a Separate State Program effective June 2002.)

This last figure represents (check one):

____ The average monthly total for the fiscal year.

__X_ The total served over the fiscal year.

9. Eligibility Criteria for Receiving MOE-funded Benefits or Services under the Program:
Maintenance of Efforts funds are used primarily to provide assistance to children. Biological or adoptive parents and step-parents may apply for assistance for a child and must be included in the payment for the family, unless they are disqualified from the program. Children are eligible for benefits through age 17. Children age 18, if in high school and expected to graduate by age 19, can receive through the month they turn 19 or graduate from high school, whichever occurs first. In order for non-custodial parents of Work First children, former Work First families, and other families with children to receive appropriate services, the family’s income and resources must meet the Eligibility Requirements as outlined in the TANF State Plan for North Carolina.

10. Prior Program Authorization: Was this program authorized and allowable under prior law (i.e., as defined at §260.30)? (check one)

Yes ___ No _X_

11. Total Program Expenditures in FY 1995. $ 0
(NOTE: provide only if the response on to question 10 is No.) This program did not exist in FY 1995.

This certifies that all families for which the State claims MOE expenditures for the fiscal year meet the State's criteria for "eligible families."

SIGNATURE:
NAME: Carmen Hooker Odom
TITLE: Secretary, North Carolina DHHS
Approved OMB No. 0970-0199 Form ACF 204, expires 6/30/2002.

Attachment B

Annual Report on State Maintenance-of-Effort Programs: Form ACF-204

State: North Carolina      Fiscal Year: 2004

Date Submitted: December 17, 2004

Provide the following information for EACH PROGRAM (according to the nature of the benefit or service provided) for which the State claims MOE expenditures. Complete and submit this report in accordance with the attached instructions.

1. Name of Benefit or Service Program: Work Subsidies

2. Description of the Major Program Benefits, Services, and Activities:

Services include On-the-Job Training and Subsidized Employment. For OJT each individual county based on the circumstances locally will determine the amount of subsidy. On-the-job training may occur in any non-profit, for profit, public or private setting. Participation in this activity offers the opportunity to learn a new trade in a supportive environment, while transitioning into a regular, unsubsidized employee status. Subsidized employment is an employment opportunity in public, private, for-profit, or not-for-profit situations where the participant’s wage is not paid entirely by the employer. The employment may be subsidized from any source. Counties may include wage supplementation in their plan

3. Purpose(s) of Benefit or Service Program:

The State uses Work Subsidies as a Service Program component to meet the statutory and regulatory TANF purpose of ending the dependence of needy parents on government benefits by promoting job preparation, work, and marriage.

4. Program Type. (Check one)

_X_ This Program is operated under the TANF program.

___ This Program is a separate State program.

5. Description of Work Activities (Complete only if this program is a separate State program):

N/A

6. Total State Expenditures for the Program for the Fiscal Year: $ 6,513

7. Total State MOE Expenditures under the Program for the Fiscal Year: $ 6,513

8. Total Number of Families Served under the Program with MOE Funds: 461
(Note: This is an estimated count of individuals obtained by applying the relative percentage of MOE expenditures to unduplicated recipient counts; family counts are not available)

This last figure represents (check one):

___ The average monthly total for the fiscal year.

_X_ The total served over the fiscal year.

9. Financial Eligibility Criteria for Receiving MOE-funded Program Benefits or Services:

Maintenance of Efforts funds are used primarily to provide assistance to children. Biological or adoptive parents and step-parents may apply for assistance for a child and must be included in the payment for the family, unless they are disqualified from the program. Children are eligible for benefits through age 17. Children age 18, if in high school and expected to graduate by age 19, can receive through the month they turn 19 or graduate from high school, whichever occurs first. In order for non-custodial parents of Work First children, former Work First families, and other families with children to receive appropriate services, the family’s income and resources must meet the requirements as outlined in the TANF State Plan for North Carolina.

10. Prior Program Authorization: Was this program authorized and allowable under prior law?
(check one)

Yes _X_ No ____

11. Total Program Expenditures in FY 1995.
(NOTE: provide only if the response on to question 10 is No.)

This certifies that all families for which the State claims MOE expenditures for the fiscal year meet the State’s criteria for “eligible families.”

SIGNATURE:
NAME: Carmen Hooker Odom
TITLE: Secretary, North Carolina DHHS
Approved OMB No. 0970-0199 Form ACF 204, expires 6/30/2002.

Attachment B

Annual Report on State Maintenance-of-Effort Programs: ACF-204

State: North Carolina      Fiscal Year: 2004

Date Submitted: December 17, 2004

Provide the following information for EACH PROGRAM for which the State claims MOE expenditures.

1. Name of Benefit or Service Program: Education and Training

2. Description of the Major Program Benefits, Services, and Activities:

Costs and expenses required for participation in a vocational or technical skills training program, leading to a specific occupation. Examples of expenses required for participation include tools, fees, supplies, and tuition when funds are not otherwise available (e.g., financial aid). Also included are the costs and expenses required for participation in a high school education program designed to prepare an individual for a high school diploma or equivalency certificate. This also includes basic and remedial education and education in English proficiency for those individuals whose native language is not English. In very limited instances, this could include the costs and expenses required for participation in an institution of higher education that is intended to result in a bachelor’s degree.

3. Purpose(s) of Benefit or Service Program:

The State uses Education and Training as a Service Program component to meet the statutory and regulatory TANF purpose of ending the dependence of needy parents on government benefits by promoting job preparation, work, and marriage.

4. Program Type. (Check one)

_X_ This Program is operated under the TANF program.

___ This Program is a separate State program.

5. Description of Work Activities in the SSP-MOE program (I.e., Complete only if this program is a separate State program):
N/A

6. Total State Expenditures for the Program for the Fiscal Year: $ 1,917,195

7. Total State Expenditures Claimed as MOE under the Program for the Fiscal Year: $ 1,917,195

8. Total Number of Families Served under the Program with MOE Funds: 10,757
(Note: This is an estimated count of individuals obtained by applying the relative percentage of MOE expenditures to unduplicated recipient counts; family counts are not available)

This last figure represents (check one):

___ The average monthly total for the fiscal year.

_X_ The total served over the fiscal year.

9. Eligibility Criteria for Receiving MOE-funded Benefits or Services under the Program:

Maintenance of Efforts funds are used primarily to provide assistance to children. Biological or adoptive parents and step-parents may apply for assistance for a child and must be included in the payment for the family, unless they are disqualified from the program. Children are eligible for benefits through age 17. Children age 18, if in high school and expected to graduate by age 19, can receive through the month they turn 19 or graduate from high school, whichever occurs first. In order for non-custodial parents of Work First children, former Work First families, and other families with children to receive appropriate services, the family’s income must be at or below 200 percent of the federal poverty guideline.

10. Prior Program Authorization: Was this program authorized and allowable under prior law (i.e., as defined at §260.30)? (check one)

Yes _X_ No ___

11. Total Program Expenditures in FY 1995.
(NOTE: provide only if the response on to question 10 is No.)

This certifies that all families for which the State claims MOE expenditures for the fiscal year meet the State's criteria for "eligible families."

SIGNATURE:
NAME: Carmen Hooker Odom
TITLE: Secretary, North Carolina DHHS
Approved OMB No. 0970-0199 Form ACF 204, expires 6/30/2002.

Attachment B

Annual Report on State Maintenance-of-Effort Programs: ACF-204

State: North Carolina      Fiscal Year: 2004

Date Submitted: December 17, 2004

Provide the following information for EACH PROGRAM for which the State claims MOE expenditures.

1. Name of Benefit or Service Program: Employment Services

2. Description of the Major Program Benefits, Services, and Activities:

Services directed toward Job Development and Placement, and Job Search and Readiness. Job Development and Placement activities include soliciting job slots and interviews for Work First participants from public and private employers, employment following the referral of the participant to a potential employer, and staff time spent in these activities. Job Search/Job Readiness includes activities to provide information on job leads; to teach job seeking and retention skills, conflict management, substance abuse counseling/treatment, goal-setting, and household budgeting. Job Search also includes participant contact with employers to arrange interviews, the actual interview process, and providing feedback to the Work First case manager. Also included are expenses and costs required for participation in Job Search/Job Readiness activities such as fees and supplies, as well as staff time spent conducting these activities.

3. Purpose(s) of Benefit or Service Program:

The State uses Employment Services as a Service Program component to meet the statutory and regulatory TANF purpose of ending the dependence of needy parents on government benefits by promoting job preparation, work, and marriage.

4. Program Type. (Check one)

_X_ This Program is operated under the TANF program.

____ This Program is a separate State program.

5. Description of Work Activities in the SSP-MOE program (I.e., Complete only if this program is a separate State program):
N/A

6. Total State Expenditures for the Program for the Fiscal Year: $ 810,433

7. Total State Expenditures Claimed as MOE under the Program for the Fiscal Year $ 810,433

8. Total Number of Families Served under the Program with MOE Funds: 11,689
(Note: This is an estimated count of individuals obtained by applying the relative percentage of MOE expenditures to unduplicated recipient counts; family counts are not available)

This last figure represents (check one):

___ The average monthly total for the fiscal year.

_X_ The total served over the fiscal year.

9. Eligibility Criteria for Receiving MOE-funded Benefits or Services under the Program:

Maintenance of Efforts funds are used primarily to provide assistance to children. Biological or adoptive parents and step-parents may apply for assistance for a child and must be included in the payment for the family, unless they are disqualified from the program. Children are eligible for benefits through age 17. Children age 18, if in high school and expected to graduate by age 19, can receive through the month they turn 19 or graduate from high school, whichever occurs first. In order for non-custodial parents of Work First children, former Work First families, and other families with children to receive appropriate services, the family’s income must be at or below 200 percent of the federal poverty guideline.

10. Prior Program Authorization: Was this program authorized and allowable under prior law (i.e., as defined at §260.30)? (check one)

Yes _X_ No ____

11. Total Program Expenditures in FY 1995.
(NOTE: provide only if the response on to question 10 is No.)

This certifies that all families for which the State claims MOE expenditures for the fiscal year meet the State's criteria for "eligible families."

SIGNATURE:
NAME: Carmen Hooker Odom
TITLE: Secretary, North Carolina DHHS
Approved OMB No. 0970-0199 Form ACF 204, expires 6/30/2002.

Attachment B

Annual Report on State Maintenance-of-Effort Programs: ACF-204

State: North Carolina      Fiscal Year: 2004

Date Submitted: December 17, 2004

Provide the following information for EACH PROGRAM for which the State claims MOE expenditures.

1. Name of Benefit or Service Program: Subsidized Child Care

2. Description of the Major Program Benefits, Services, and Activities:

Assistance with the cost of child care for families with incomes at or below 200% of the federal poverty level and who need child care in order to work. (See North Carolina’s Work First State Plan.)

3. Purpose(s) of Benefit or Service Program:

The State uses Subsidized Child-Care as a Services Program component to meet the statutory and regulatory TANF purpose of providing assistance to needy families so that children may be cared for in their homes or in the homes of relatives; and to end dependence of needy parents on government benefits by promoting job preparation, work, and marriage.

4. Program Type. (Check one)

_X_ This Program is operated under the TANF program.

____ This Program is a separate State program.

5. Description of Work Activities in the SSP-MOE program (I.e., Complete only if this program is a separate State program):
N/A

6. Total State Expenditures for the Program for the Fiscal Year: $ 71,282,343

7. Total State Expenditures Claimed as MOE under the Program for the Fiscal Year: $ 71,282,343

8. Total Number of Families Served under the Program with MOE Funds: 8,753

This last figure represents (check one):

_X_ The average monthly total for the fiscal year.

___ The total served over the fiscal year.

9. Eligibility Criteria for Receiving MOE-funded Benefits or Services under the Program:

Maintenance of Efforts funds are used primarily to provide assistance to children. Biological or adoptive parents and step-parents may apply for assistance for a child and must be included in the payment for the family, unless they are disqualified from the program. Children are eligible for benefits through age 17. Children age 18, if in high school and expected to graduate by age 19, can receive through the month they turn 19 or graduate from high school, whichever occurs first. In order for non-custodial parents of Work First children, former Work First families, and other families with children to receive appropriate services, the family’s income must be at or below 200 percent of the federal poverty guideline.

10. Prior Program Authorization: Was this program authorized and allowable under prior law (i.e., as defined at §260.30)? (check one)

Yes _X_ No ____

11. Total Program Expenditures in FY 1995.
(NOTE: provide only if the response on to question 10 is No.)

This certifies that all families for which the State claims MOE expenditures for the fiscal year meet the State's criteria for "eligible families."

SIGNATURE:
NAME: Carmen Hooker Odom
TITLE: Secretary, North Carolina DHHS
Approved OMB No. 0970-0199 Form ACF 204, expires 6/30/2002.

Attachment B

Annual Report on State Maintenance-of-Effort Programs: ACF-204

State: North Carolina      Fiscal Year: 2004

Date Submitted: December 17, 2004

Provide the following information for EACH PROGRAM for which the State claims MOE expenditures.

1. Name of Benefit or Service Program: Information and Case Management Services

2. Description of the Major Program Benefits, Services, and Activities:
Activities include Work First Information/Referral services and Case Management Without Eligibility Determination. (See Work First Policy Manual and Attachment ICMS-1.)

3. Purpose(s) of Benefit or Service Program:

The State uses Information and Case Management Services as a Service Program component to meet the statutory and regulatory TANF purposes of ending the dependence of needy parents on government benefits by promoting job preparation, work, and marriage; prevent and reduce the incidence of out-of-wedlock pregnancies and establish annual numerical goals for preventing and reducing the incidence of these pregnancies; and encourage the formation and maintenance of two-parent families.

4. Program Type. (Check one)

_X_ This Program is operated under the TANF program.

___ This Program is a separate State program.

5. Description of Work Activities in the SSP-MOE program (I.e., Complete only if this program is a separate State program):
N/A

5. Total State Expenditures for the Program for the Fiscal Year: $ 48,176,379

7. Total State Expenditures Claimed as MOE under the Program for the Fiscal Year: $ 48,176,379

8. Total Number of Families Served under the Program with MOE Funds: 3,768
(Note: This is an unduplicated count of individuals; family counts are not available.)

This last figure represents (check one):

___ The average monthly total for the fiscal year.

_X_ The total served over the fiscal year.

9. Eligibility Criteria for Receiving MOE-funded Benefits or Services under the Program:

Maintenance of Efforts funds are used primarily to provide assistance to children. Biological or adoptive parents and step-parents may apply for assistance for a child and must be included in the payment for the family, unless they are disqualified from the program. Children are eligible for benefits through age 17. Children age 18, if in high school and expected to graduate by age 19, can receive through the month they turn 19 or graduate from high school, whichever occurs first. In order for non-custodial parents of Work First children, former Work First families, and other families with children to receive appropriate services, the family’s income must be at or below 200 percent of the federal poverty guideline.

10. Prior Program Authorization: Was this program authorized and allowable under prior law (i.e., as defined at §260.30)? (check one)

10. Prior Program Authorization: Was this program authorized and allowable under prior law (i.e., as defined at §260.30)? (check one)

Yes X No

11. Total Program Expenditures in FY 1995.
(NOTE: provide only if the response on to question 10 is No.)

This certifies that all families for which the State claims MOE expenditures for the fiscal year meet the State's criteria for "eligible families."

SIGNATURE:
NAME: Carmen Hooker Odom
TITLE: Secretary, North Carolina DHHS
Approved OMB No. 0970-0199 Form ACF 204, expires 6/30/2002.

Description of the Major Program Benefits, Services, and Activities

Work First Information/Referral: Providing information about the Work First Program to Work First Family Assistance recipients and the general public. Activities include but are not limited to, providing an explanation of Work First, including employment services, support services available to Work First families, non-custodial parents or former Work First families with income at or below 200% of the poverty level, assistance with child support, and temporary cash assistance, and a general overview of participant and agency responsibilities. Referrals to other programs and resources may also be included.

Also included is time spent identifying and developing community resources for work and work-related activities and supportive services. This includes working with businesses, establishing and supporting local business councils, working with the Faith Community and other non-profit organizations. Faith and community liaisons should generally use this code to record their time.

Activities include explaining program policy to agency providers, developing memoranda of understanding with local agencies, and monitoring feedback. Accessing labor market information, public awareness, posting worksite and employment opportunities are included in this service. General development and negotiation of OJT and Job Development and Job Placement contracts are included in this activity.

Case Management Without Eligibility Determination: Planning and directing the provision of, and/or directly providing services by Work First staff with case management responsibilities as defined in Work First policies and procedures. These staff do not determine eligibility for Work First Family Assistance. Activities include ongoing evaluation of the individual's current program participation and service needs and appropriate modifications to the Mutual Responsibility Agreement. This also includes providing the appropriate assistance to enable the participant to assume responsibility for identifying and accessing those services necessary to promote successful program participation, and employment. Some services identified as case management include: initial assessment and periodic reassessment of a participant's job readiness, job search, examination of constructive ways to resolve all work-related issues, mutually-developed strategies (by the participant and worker) for self-sufficiency, identification of responsibilities of both the participant and agency in facilitating the completion of the plan; arranging and/or providing transportation, and arranging child/adult care.

Case management activities assist families to independently conduct routine tasks such as recognizing family health needs, utilizing maternal and child health programs, and performing daily household management tasks, which contribute to self-sufficiency.

Attachment B

Annual Report on State Maintenance-of-Effort Programs: ACF-204

State: North Carolina      Fiscal Year: 2004

Date Submitted: December 17, 2004

Provide the following information for EACH PROGRAM for which the State claims MOE expenditures.

1. Name of Benefit or Service Program: Other Work First Services

2. Description of the Major Program Benefits, Services, and Activities:

Activities include the provision of Mental Health services, Housing Expenditures Other Than Housing Subsidies, and Other Work First Services. See Attachment OWFS-1 for a detailed description of these services.

3. Purpose(s) of Benefit or Service Program:

The State uses Other Work First Services as a Service Program component to meet the statutory and regulatory TANF purposes of ending the dependence of needy parents on government benefits by promoting job preparation, work, and marriage; and encourage the formation and maintenance of two parent families.

4. Program Type. (Check one)

_X_ This Program is operated under the TANF program.

____ This Program is a separate State program.

5. Description of Work Activities in the SSP-MOE program (I.e., Complete only if this program is a separate State program):
N/A

6. Total State Expenditures for the Program for the Fiscal Year: $ 897,593

7. Total State Expenditures Claimed as MOE under the Program for the Fiscal Year: $ 897,593

8. Total Number of Families Served under the Program with MOE Funds: 1,165
(Note: This is an unduplicated count of individuals; family counts are not available.)

This last figure represents (check one):

___ The average monthly total for the fiscal year.

_X_ The total served over the fiscal year.

9. Eligibility Criteria for Receiving MOE-funded Benefits or Services under the Program:

Maintenance of Efforts funds are used primarily to provide assistance to children. Biological or adoptive parents and step-parents may apply for assistance for a child and must be included in the payment for the family, unless they are disqualified from the program. Children are eligible for benefits through age 17. Children age 18, if in high school and expected to graduate by age 19, can receive through the month they turn 19 or graduate from high school, whichever occurs first. In order for non-custodial parents of Work First children, former Work First families, and other families with children to receive appropriate services, the family’s income must be at or below 200 percent of the federal poverty guideline.

10. Prior Program Authorization: Was this program authorized and allowable under prior law (i.e., as defined at §260.30)? (check one)

Yes _X_ No ____

11. Total Program Expenditures in FY 1995.
(NOTE: provide only if the response on to question 10 is No.)

This certifies that all families for which the State claims MOE expenditures for the fiscal year meet the State's criteria for "eligible families."

SIGNATURE:
NAME: Carmen Hooker Odom
TITLE: Secretary, North Carolina DHHS
Approved OMB No. 0970-0199 Form ACF 204, expires 6/30/2002

Description of the Major Program Benefits, Services, and Activities

Mental Health Services: Helping Work First participants to obtain mental health services necessary to enable them to participate in Work First activities as specified in the Personal/Mutual Responsibility Contract. Services will also be available to the participant’s family members, if needed, to support the participant’s plan. Services include helping families recognize needs, assisting individuals to secure admission to institutions as needed, and referrals to appropriate resources.

Services include the provision of counseling services or therapy to Work First participants and their families for the purpose of resolving emotional conflicts and to enable the participant to reach his/her employment goal. This process involves a professional relationship with a skilled counselor to assist the participant to assess the situation and to identify and implement strategies for resolution.

Other Supportive Services: All other services provided to assist Work First participants in meeting the conditions of the Mutual Responsibility Agreement as allowed in policy. Allowable services include, but are not limited to: Services provided by qualified paraprofessionals, i.e., in-home aides, and case management support staff, who are trained, equipped, assigned, and supervised by DSS staff to assist in the case management function to maintain and strengthen the family unit. These services include providing assistance with home management tasks, providing transportation, and preparing for participant groups.

Work First Housing Expenditures – Other Than Housing Subsidies: Any costs, other than subsidies, used to provide housing assistance to eligible families. This may include costs such as, staff time for a housing coordinator, housing/financial counseling, costs associated with operation of the Work First Housing pilots, and contracts with non-profits to provide housing assistance.

Attachment B

Annual Report on State Maintenance-of-Effort Programs: ACF-204

State: North Carolina      Fiscal Year: 2004

Date Submitted: December 17, 2004

Provide the following information for EACH PROGRAM for which the State claims MOE expenditures.

1. Name of Benefit or Service Program: Retention Services for the Employed

2. Description of the Major Program Benefits, Services, and Activities:

Services provided to former Work First cash recipients and eligible families who have never received Work First whose incomes are at or below 200% of Federal Poverty Level, including but not limited to, transportation, child care, job retention bonuses and services, child and family enrichment services, support services, employment services, and preventive family services, case management, follow-up, mentoring, after school learning programs, parenting programs, literacy programs, and post- employment skills training. (See North Carolina’s Work First State Plan, page 5.)

3. Purpose(s) of Benefit or Service Program:

The State uses Retention Services for the Employed as a Service Program component to meet the statutory and regulatory TANF purposes of ending the dependence of needy parents on government benefits by promoting job preparation, work, and marriage; prevent and reduce the incidence of out-of-wedlock pregnancies and establish annual numerical goals for preventing and reducing the incidence of these pregnancies; and encourage the formation and maintenance of two parent families.

4. Program Type. (Check one)

_X_ This Program is operated under the TANF program.

____ This Program is a separate State program.

5. Description of Work Activities in the SSP-MOE program (I.e., Complete only if this program is a separate State program):
N/A

6. Total State Expenditures for the Program for the Fiscal Year: $ 2,472,043

7. Total State Expenditures Claimed as MOE under the Program for the Fiscal Year: $ 2,472,043

8. Total Number of Families Served under the Program with MOE Funds: 14,854
(Note: This is a combination of an unduplicated count of individuals served with MOE funds and estimated counts of individuals obtained by applying the relative percentages of MOE expenditures to unduplicated recipient counts; family counts are not available.)

This last figure represents (check one):

___ The average monthly total for the fiscal year.

_X_ The total served over the fiscal year.

9. Eligibility Criteria for Receiving MOE-funded Benefits or Services under the Program:

Maintenance of Efforts funds are used primarily to provide assistance to children. Biological or adoptive parents and step-parents may apply for assistance for a child and must be included in the payment for the family, unless they are disqualified from the program. Children are eligible for benefits through age 17. Children age 18, if in high school and expected to graduate by age 19, can receive through the month they turn 19 or graduate from high school, whichever occurs first. In order for non-custodial parents of Work First children, former Work First families, and other families with children to receive appropriate services, the family’s income must be at or below 200 percent of the federal poverty guideline.

10. Prior Program Authorization: Was this program authorized and allowable under prior law (i.e., as defined at §260.30)? (check one)

Yes _X_ No ___

11. Total Program Expenditures in FY 1995.
(NOTE: provide only if the response on to question 10 is No.)

This certifies that all families for which the State claims MOE expenditures for the fiscal year meet the State's criteria for "eligible families."

SIGNATURE:
NAME: Carmen Hooker Odom
TITLE: Secretary, North Carolina DHHS
Approved OMB No. 0970-0199 Form ACF 204, expires 6/30/2002.

Attachment B

Annual Report on State Maintenance-of-Effort Programs: ACF-204

State: North Carolina      Fiscal Year: 2004

Date Submitted: December 17, 2004

Provide the following information for EACH PROGRAM for which the State claims MOE expenditures.

1. Name of Benefit or Service Program: Specialized Work First Services

2. Description of the Major Program Benefits, Services, and Activities:

Specialized services designed to allow Work First recipients to participate in approved activities and to assist families in the transition from welfare to self-sufficiency. Services include Substance Abuse Services, Child and Family Enrichment, and Medical Insurance Premiums. (See Attachment SWFS-1 for detailed descriptions of these services.)

3. Purpose(s) of Benefit or Service Program:

The State uses Specialized Work First Services as a Service Program component to meet the statutory and regulatory TANF purpose of ending the dependence of needy parents on government benefits by promoting job preparation, work, and marriage.

4. Program Type. (Check one)

_X_ This Program is operated under the TANF program.

___ This Program is a separate State program.

5. Description of Work Activities in the SSP-MOE program (I.e., Complete only if this program is a separate State program):
N/A

6. Total State Expenditures for the Program for the Fiscal Year: $ 335,067

7. Total State Expenditures Claimed as MOE under the Program for the Fiscal Year: $ 335,067

8. Total Number of Families Served under the Program with MOE Funds: 299
(Note: This is a combination of unduplicated counts of individuals served with MOE funds for some service components and estimated counts of individuals obtained by applying the relative percentage of MOE expenditures to unduplicated counts of all recipients of other components; family counts are not available.)

This last figure represents (check one):

___ The average monthly total for the fiscal year.

_X_ The total served over the fiscal year.

9. Eligibility Criteria for Receiving MOE-funded Benefits or Services under the Program:

Maintenance of Efforts funds are used primarily to provide assistance to children. Biological or adoptive parents and step-parents may apply for assistance for a child and must be included in the payment for the family, unless they are disqualified from the program. Children are eligible for benefits through age 17. Children age 18, if in high school and expected to graduate by age 19, can receive through the month they turn 19 or graduate from high school, whichever occurs first. In order for non-custodial parents of Work First children, former Work First families, and other families with children to receive appropriate services, the family’s income must be at or below 200 percent of the federal poverty guideline.

10. Prior Program Authorization: Was this program authorized and allowable under prior law (i.e., as defined at §260.30)? (check one)

Yes ____ No _X_

11. Total Program Expenditures in FY 1995. $ 0
(NOTE: provide only if the response on to question 10 is No.) This program did not exist in FY 1995.

This certifies that all families for which the State claims MOE expenditures for the fiscal year meet the State's criteria for "eligible families."

SIGNATURE:
NAME: Carmen Hooker Odom
TITLE: Secretary, North Carolina DHHS
Approved OMB No. 0970-0199 Form ACF 204, expires 6/30/2002.

Description of the Major Program Benefits, Services, and Activities

Substance Abuse Services: Helping Work First participants obtain the substance abuse services necessary to enable them to participate in Work First activities as specified in the Personal/Mutual Responsibility Contract. Services will also be available to the participant’s family members, if needed, to support the participant’s plan. Services include helping families recognize needs, assisting individuals secure admission to appropriate treatment programs, and referral to appropriate resources. This includes the services leading up to the diagnosis, the cost of the diagnosis, and the cost of treatment to the extent these services are not covered by any other source.

Child And Family Enrichment Services: Services and activities that enhance parents’ and children’s ability to become self-sufficient, properly care for children, and enhance school performance and behavior, self-esteem and leadership skills, and family relationships. The services do not have to be solely and directly related to employment, but must be provided to protect, support, and/or enhance the lives and futures of the parents/caretakers and children involved. The services should be related to helping families and children transition from welfare to self-sufficiency. Examples of such services include, but are not limited to, after-school mentoring and tutoring, parenting skills, summer enrichment programs such as specially designed 4H camp enrichment programs, and family counseling services. Services will primarily be purchased services but could be provided by an agency staff member responsible for providing such services. These services may be provided for current Work First cash assistance families as well as families that are not current Work First recipients but have gross income at or below 200% of the federal poverty guideline and meet the other requirements outlined in Section 118 of the Work First manual.

Medical Insurance Premiums: Payment of medical insurance premiums for Work First eligible families and or children, including the NC Health Choice for Children Program. Allowable expenditures may include full or partial payment of the medical insurance premium or full or partial subsidy of family medical insurance available through an employer. Counties may consider subsidizing employment related medical insurance for a limited period of time possibly with a decreasing subsidy over time. Families eligible for help with medical insurance premiums must be Work First cash assistance recipients or families with income at or below 200% of the federal poverty level who meet all eligibility requirements for that group. Medical insurance premiums are limited to MOE funds.

Attachment B

Annual Report on State Maintenance-of-Effort Programs: ACF-204

State: North Carolina      Fiscal Year: 2004

Date Submitted: December 17, 2004

Provide the following information for EACH PROGRAM for which the State claims MOE expenditures.

1. Name of Benefit or Service Program: Transportation Services

2. Description of the Major Program Benefits, Services, and Activities:

(See North Carolina’s Work First State Plan, page 4). The North Carolina Department of Transportation (NCDOT) and the North Carolina Department of Health and Human Services (NCDHHS) share a mutual interest in exploring new and innovative resources for employment transportation. The common goal is to move welfare recipients not only to work but also to self-sufficiency. Since April 1998, NCDOT has provided an annual allocation of $1 million across the state to support the employment transportation needs of former Work First recipients that are working and no longer eligible to receive cash assistance. The formula-based allocation entitled “Work First Transitional/Employment Transportation Assistance” is made available to each county based on population and welfare caseload size. Funds may be used for fuel, bus passes, vanpooling and carpooling efforts, volunteer reimbursement, driver wages/fringe benefits, taxi services, insurance, repairs, and maintenance. Although these funds are targeted towards former Work First recipients, they may also be used for other low-income individuals in the community with employment-related transportation needs who are not affiliated with Work First or other human service programs.

Counties are encouraged to develop local partnerships with other human services agencies, transit systems, businesses, workforce development agencies, faith community, civic organizations, etc. to develop and expand alternative transportation resources to meet the community’s transportation needs. Issues such as communication, coordination, trust, policies, marketing, funding resources and cost sharing are all part of the discussion process.

Many counties have developed car ownership programs through partnerships with other organizations. Vehicles donated from private citizens, businesses, and/or local governments are given to select Work First families. There are many different versions of car ownership programs in operation in North Carolina. Most programs require that the Work First recipient pay at least a portion of the costs associated with liability insurance, repairs, taxes, and license and/or title fees. Some counties use Work First Block Grant Funds to purchase vehicles, make down payments and assist with regular car payments for Work First families.

3. Purpose(s) of Benefit or Service Program:

The State uses Transportation Services as a Service Program component to meet the statutory and regulatory TANF purpose ending the dependence of needy parents on government benefits by promoting job preparation, work and marriage.

4. Program Type. (Check one)

_X_ This Program is operated under the TANF program.

____ This Program is a separate State program.

5. Description of Work Activities in the SSP-MOE program (I.e., Complete only if this program is a separate State program):
N/A

6. Total State Expenditures for the Program for the Fiscal Year: $ 4,463,438

7. Total State Expenditures Claimed as MOE under the Program for the Fiscal Year: $ 4,463,438

8. Total Number of Families Served under the Program with MOE Funds: 3,062*
(*Note: North Carolina does not normally track the number of individuals receiving this service. The value shown represents an estimated count of individuals obtained by applying the relative percentage of MOE expenditures to an unduplicated recipient count from one month (September 2004) of the Fiscal Year.)

This last figure represents (check one):

_X_ The average monthly total for the fiscal year.

___ The total served over the fiscal year.

9. Eligibility Criteria for Receiving MOE-funded Benefits or Services under the Program:

Maintenance of Efforts funds are used primarily to provide assistance to children. Biological or adoptive parents and step-parents may apply for assistance for a child and must be included in the payment for the family, unless they are disqualified from the program. Children are eligible for benefits through age 17. Children age 18, if in high school and expected to graduate by age 19, can receive through the month they turn 19 or graduate from high school, whichever occurs first. In order for non-custodial parents of Work First children, former Work First families, and other families with children to receive appropriate services, the family’s income must be at or below 200 percent of the federal poverty guideline.

10. Prior Program Authorization: Was this program authorized and allowable under prior law (i.e., as defined at §260.30)? (check one)

Yes _X_ No ____

11. Total Program Expenditures in FY 1995.
(NOTE: provide only if the response on to question 10 is No.)

This certifies that all families for which the State claims MOE expenditures for the fiscal year meet the State's criteria for "eligible families."

SIGNATURE:
NAME: Carmen Hooker Odom
TITLE: Secretary, North Carolina DHHS
Approved OMB No. 0970-0199 Form ACF 204, expires 6/30/2002.

Attachment B

Annual Report on State Maintenance-of-Effort Programs: ACF-204

State: North Carolina      Fiscal Year: 2004

Date Submitted: December 17, 2004

Provide the following information for EACH PROGRAM for which the State claims MOE expenditures.

1. Name of Benefit or Service Program: Work First Administration

2. Description of the Major Program Benefits, Services, and Activities:

(See North Carolina’s Work First State Plan). The N. C. Department of Health and Human Services is responsible for establishing, supervising, and monitoring the Work First Program. At present, all services and benefits are delivered locally by county departments of social services in each of North Carolina’s 100 counties, although Electing Counties may choose to designate an alternative service delivery agent.
Each Standard County must submit biennially to the Department of Health and Human Services for approval, a local block grant plan that describes its proposed Work First Employment Services Program, emergency assistance, and optional components, including retention and follow-up services, support and preventive services, and work-related services for non-custodial parents of Work First children. Each Electing County must submit biennially to the Department of Health and Human Services a local block grant plan that describes its proposed Work First Employment Services, Eligibility Criteria, emergency assistance, and Benefit Diversion Programs, and optional components, including retention and follow-up services, support and preventive services, and services for non-custodial parents of Work First children. The public must have an opportunity to review and comment upon local block grant plans before they are submitted to the Department. The county board of commissioners must appoint a committee of individuals to identify the needs of the population to be served and to review and assist in developing the county block grant plan in response to the needs. Membership of the committee must include, but is not limited to, representatives of the county board of social services, the board of the area mental health authority, the local public health board, the local school systems, the business community, the board of county commissioners and community-based organizations that are representative of the population to be served. In addition, religious organizations, service recipients, and other non-profits with experience in serving the population should be included. Work First Administration covers the federal definition of administration as stated in 45 CFR 263.0.

The local block grant plan should include public and private resources that will help families move to self-sufficiency and should describe how services such as child care, transportation, housing, and skills training will be used. The plan must include the county’s priorities for serving families who need child care, based on the needs of the community and the availability of services and funding.

3. Purpose(s) of Benefit or Service Program:

The State uses Work First Administration as a Benefit and Service Program component to meet the statutory and regulatory TANF purposes of providing assistance to needy families so that children may be cared for in their own homes or in the homes of relatives; end the dependence of needy parents on government benefits by promoting job preparation, work, and marriage; prevent and reduce the incidence of out-of-wedlock pregnancies and establish annual numerical goals for preventing and reducing the incidence of these pregnancies; and encourage the formation and maintenance of tow parent families.

4. Program Type. (Check one)

_X_ This Program is operated under the TANF program.

___ This Program is a separate State program.

5. Description of Work Activities in the SSP-MOE program (I.e., Complete only if this program is a separate State program):
N/A

6. Total State Expenditures for the Program for the Fiscal Year: $ 17,750,278

7. Total State Expenditures Claimed as MOE under the Program for the Fiscal Year: $ 17,750,278

8. Total Number of Families Served under the Program with MOE Funds: 953
(Note: This is a combination of an unduplicated recipient count and an estimated count of individuals obtained by applying the relative percentage of MOE expenditures to an unduplicated recipient count. This count refers only to specific activities related to eligibility determination and fraud investigation activities.)

This last figure represents (check one):

___ The average monthly total for the fiscal year.

_X_ The total served over the fiscal year.

9. Eligibility Criteria for Receiving MOE-funded Benefits or Services under the Program:

Maintenance of Efforts funds are used primarily to provide assistance to children. Biological or adoptive parents and step-parents may apply for assistance for a child and must be included in the payment for the family, unless they are disqualified from the program. Children are eligible for benefits through age 17. Children age 18, if in high school and expected to graduate by age 19, can receive through the month they turn 19 or graduate from high school, whichever occurs first. In order for non-custodial parents of Work First children, former Work First families, and other families with children to receive appropriate services, the family’s income must be at or below 200 percent of the federal poverty guideline.

10. Prior Program Authorization: Was this program authorized and allowable under prior law (i.e., as defined at §260.30)? (check one)

Yes _X_ No ___

11. Total Program Expenditures in FY 1995.
(NOTE: provide only if the response on to question 10 is No.)

This certifies that all families for which the State claims MOE expenditures for the fiscal year meet the State's criteria for "eligible families."

SIGNATURE:
NAME: Carmen Hooker Odom
TITLE: Secretary, North Carolina DHHS
Approved OMB No. 0970-0199 Form ACF 204, expires 6/30/2002.

Attachment B

Annual Report on State Maintenance-of-Effort Programs: ACF-204

State: North Carolina      Fiscal Year: 2004

Date Submitted: December 17, 2004

Provide the following information for EACH PROGRAM for which the State claims MOE expenditures.

1. Name of Benefit or Service Program: Automation Systems

2. Description of the Major Program Benefits, Services, and Activities:

The Department has developed a plan that will integrate the traditional eligibility determination and benefit delivery components with case management tools required in today’s environment. The approach, which is driven by business needs, centers on the phased-in delivery of critical components. Specific components of the plan include a statewide network to support e-mail and exchange of information among agencies, interfaces among systems, compliance with federal requirements without manual intervention, case management and tracking, a data warehouse for statistical analysis, assessment of outcomes and improved reporting, enhanced fraud and abuse tracking, development of new service delivery tools, user training and office readiness, skilled project management, and on-line policy manuals. (See North Carolina’s Work First State Plan, page 10.)

3. Purpose(s) of Benefit or Service Program:
The State uses the Automation System as a Benefit and Service component to meet the statutory and regulatory TANF purpose of providing assistance to needy families so that children may be cared for in their own homes or in the homes of relatives.

4. Program Type. (Check one)

_X_ This Program is operated under the TANF program.

____ This Program is a separate State program.

5. Description of Work Activities (Complete only if this program is a separate State program):
N/A

6. Total State Expenditures for the Program for the Fiscal Year: $ 1,351,271

7. Total State MOE Expenditures under the Program for the Fiscal Year: $ 1,351,271

8. Total Number of Families Served under the Program with MOE Funds: N/A
(Note: Family count not applicable to this program.)

This last figure represents (check one):

The average monthly total for the fiscal year.

The total served over the fiscal year.

9. Financial Eligibility Criteria for Receiving MOE-funded Program Benefits or Services:
N/A

10. Prior Program Authorization: Was this program authorized and allowable under prior law? (check one)

Yes _X_ No ____

11. Total Program Expenditures in FY 1995.
(NOTE: provide only if the response on to question 10 is No.)

This certifies that all families for which the State claims MOE expenditures for the fiscal year meet the State's criteria for "eligible families."

SIGNATURE:
NAME: Carmen Hooker Odom
TITLE: Secretary, North Carolina DHHS
Approved OMB No. 0970-0199 Form ACF 204, expires 6/30/2002.

Attachment B

Annual Report on State Maintenance-of-Effort Programs: ACF-204

State: North Carolina      Fiscal Year: 2004

Date Submitted: December 17, 2004

Provide the following information for EACH PROGRAM for which the State claims MOE expenditures.

1. Name of Benefit or Service Program: Child Welfare Services

2. Description of the Major Program Benefits, Services, and Activities:

Child Welfare Services in North Carolina encompass a broad range of services including Family Preservation and Support, Child Protective Services, Foster Care and Adoption Services, Counseling and Individual and Family Adjustment Services, In-Home Aide Services, Intake and Case Management, Housing Improvement, and other services. For a detailed list of services and activities, refer to Attachment CWS-1. (Also, See North Carolina’s Work First State Plan, page 3.)

3. Purpose(s) of Benefit or Service Program:
See Attachment CWS-1.

4. Program Type. (Check one)

_X_ This Program is operated under the TANF program.

___ This Program is a separate State program.

5. Description of Work Activities (Complete only if this program is a separate State program):
N/A

5. Total State Expenditures for the Program for the Fiscal Year: $ 12,619,116

7. Total State MOE Expenditures under the Program for the Fiscal Year: $ 12,619,116

8. Total Number of Families Served under the Program with MOE Funds: 29,020
(Note: This is an unduplicated count of individuals; family counts are not available.)

This last figure represents (check one):

___ The average monthly total for the fiscal year.

_X_ The total served over the fiscal year.

9. Financial Eligibility Criteria for Receiving MOE-funded Program Benefits or Services:
See Attachment CWS-1

10. Prior Program Authorization: Was this program authorized and allowable under prior law? (check one)

Yes _X_ No ___

11. Total Program Expenditures in FY 1995.
(NOTE: provide only if the response on to question 10 is No.)

This certifies that all families for which the State claims MOE expenditures for the fiscal year meet the State's criteria for "eligible families."

SIGNATURE:
NAME: Carmen Hooker Odom
TITLE: Secretary, North Carolina DHHS
Approved OMB No. 0970-0199 Form ACF 204, expires 6/30/2002.

Description of the Major Program Benefits, Services, and Activities, Purposes, and Eligibility Requirements

MOE funds in child welfare are used exclusively for services as opposed to financial payments such as foster care maintenance payments and adoption assistance payments. Workers are required to document the following eligibility requirements in every case:

• How the service meets TANF Goal #1 (i.e., to provide assistance to needy families so that children may be cared for in their own homes or in the homes of relatives);
• The child is either living with a parent or specified relative or, if in foster care, is considered a family of one;
• Income of the family and/or child does not exceed 200% of FPL; and
• The child is a US citizen or qualified alien.

MOE funds are used by county departments of social services to further enhance funding flexibility and to maintain funding spending levels.

Diagnostic, and Treatment Services (Non-Residential)-Adoption-Direct outpatient psychological, clinical, or therapeutic counseling or treatment provided to a child in a structured individual or group session by a qualified professional for the purposes of ameliorating or remedying personal problems, behaviors, or home conditions that endanger the stability of the adoptive placement. This code should not be used when a worker is making a referral for these services to be provided to the client, or is otherwise referring the client to these services.

This code can only used when Medicaid funding is not available.

Diagnostic and Treatment Services (Non-Residential)-Foster Care: Direct outpatient psychological, clinical, or therapeutic counseling or treatment provided to a child in a structured individual or group session by a qualified professional for the purposes of ameliorating or remedying personal problems, behaviors, or home conditions that endanger the stability of the foster placement. This code should not be used when a worker is making a referral for these services to be provided to the client, or is otherwise referring the client to these services.

This code can only used when Medicaid funding is not available.

Foster Care Services For Children - Special Services: At county option, the provision by a foster family home of services, in addition to basic foster care, which meets the special needs of children in that home.

Foster Care Services For Children -Case Management: Includes a broad range of activities related to supervising the care of the child and managing the case plan and case reviews. This includes time spent on:

• Referral to, coordination with, and utilization of other services;
• Maintenance of contact with the family and others significant to the case. This also includes aftercare services to the family when a child is placed via a court order with the parents, a relative, or a non-relative, or who has been placed on a court ordered trial home visit.
• Working with the parents on the status of the case and case goals;
• Giving information, instruction, guidance, and mentoring regarding parenting skills;
• Preparation for and participation in court, e.g., petitions, motions, reviews, reports;
• Preparation of the child and biological family for separation and placement, including negotiation/preparation of visitation agreements and any subsequent time spent on notices related to changes in where the child is living;
• Monitoring and updating the Family Services Case plan;
• Periodic reviews of case plans including foster care review team meetings;
• Supervising the care of the child and of the foster care arrangement to assure that the child receives proper care.
• Grievances, appeals, and fair hearings surrounding termination of use of foster care facilities which have been found unsuitable for the care of children, or associated with any individuals claim that benefits and services have been denied or not acted upon with reasonable promptness, or related to complaints about the agency's failure to keep parents involved in case planning, case reviews, and placement decisions.

Family Reunification Services: Services to address the problems of families whose children have been placed in foster care so that reunification may occur in a safe and stable manner in accordance with the Adoption and Safe Families Act.

Family Preservation Services: Services for children and families (including adoptive or extended families) designed to help families that are at risk of or in crisis. These services include, but are not limited to, 1) permanency planning services, 2) preplacement prevention services, 3) respite care and 4) parenting support services.

Family Support Services: Community based services to promote the well-being of children and families designed to increase the strength and stability of families (including adoptive, foster and extended families), to increase parents' confidence and competence in their parenting abilities, to afford children a stable and supportive family environment, and otherwise to enhance child development.

Intensive Family Preservation Services: Family focused, community based crisis intervention services that are designed to maintain children safely in their homes and prevent unnecessary separation of families. Such services are characterized by very small caseloads for workers, short duration of services, 24-hour availability of staff, and the provision of services primarily in the child's home or in another familiar environment.

Family Group Conferencing is a discrete service provided either by a contracted worker or workers within the agency who has been trained in the Division-approved Family Group Conferencing model and who provides the following services:

• Establishes linkages with community members to ensure appropriate service delivery for families.
• Planning, arranging, and conducting family group conferences on behalf of children reported or substantiated for abuse, neglect, or dependency, and for whom removal from the home is a reasonable possibility in the absence of effective preventative services, or on behalf of children in agency custody or placement responsibility.
• Contacting and preparing family members for conferences.
• Conducting the actual family conference.
• Collecting and reporting data related to family group conferences in order to evaluate their effectiveness.
• Arranging for and/or providing transportation, lodging for participants in the family group conference as well as arranging for and/or providing food during the actual conference sessions.

Protective Services for Children - Investigative Assessment: Activities include

• Conducting those activities necessary to determine whether or not allegations of abuse, neglect, or dependency are true, and to evaluate the safety of the child in the home.
• The primary elements of investigations as defined by law and Administrative Rule are included in this service code.
• Activities related to petitions for interference with an investigation are to be coded in this category.
• Tasks related to information gathering for the purpose of making a case decision, such as referral to CME/CMHEP, are included under this code.
• Giving information, instruction, guidance, and mentoring regarding parenting skills; ongoing determination of the need for placement; referrals to other service providers and evaluation of services provided; and gathering information for case plans.
• Completion of the investigative assessment includes the use of a shared decision making process to make a case decision, as well as case closure activities.
• Documentation of pre-placement activities and related travel time.

Protective Services for Children – Intake: Activities Include:

• Receiving and documenting a report, which alleges that, a child or children may be abused, neglected or dependent.
• Making a thorough evaluation of the information provided by the reporter to determine whether a protective services investigation will be initiated.
• Informing the person making the report of the agency's decision whether or not to investigate and their right to a review of this decision.
• Directing the reporter to other agency or community resources, when indicated.
• Making referrals to the district attorney and/or law enforcement, when indicated.
• Completing thorough documentation of the above activities.

Protective Services For Children - Medical, Psychological, and Medico-Legal Diagnostic Services: Medical, psychological and medico-legal diagnostic studies and evaluations when needed to substantiate and assess the circumstances of abuse or neglect of children.

Protective Services For Children - Case Planning and Case Management Services For Children Defined As Reasonable Candidates For Foster Care and Their Families, after there has been a substantiation of child abuse, neglect, and/or dependency and removal of the child is a reasonable possibility in the absence of such services. This code should be used when:

• Monitoring, expanding and updating the Family Services Case Plan to address identified areas of need.
• Routine case supervisory activities;
• Maintenance of contact with the family and others significant to the case.
• Working with the parents on the status of the case and case goals.
• Giving information, instruction, guidance and mentoring regarding parenting skills.
• Referral to monitoring of service as appropriate, including referrals to DSS-provided clinical treatment.
• Ongoing determination of appropriateness of need for out-of-home placement.
• Ensuring that foster care placements across state lines are in compliance with interstate compact laws.
• Documentation of Case Planning and Case Management activities.
• This code should be used for travel associated with any of the above activities.

When an allegation is not substantiated, the CPS case is closed and related activities are not IV-E reimbursable. The family may be referred to voluntary services or services outside the agency.

Diagnostic and Treatment Services (Non-Residential)-CPS: Direct outpatient psychological, clinical, or therapeutic counseling or treatment provided to a child in a structured individual or group session by a qualified professional for the purposes of ameliorating or remedying personal problems, behaviors, or home conditions. This code should not be used when a worker is making a referral for these services to be provided to the client, or is otherwise referring the client to these services.

This code can only be used when Medicaid funding is not available.

Individual And Family Adjustment Services - Camping Component: Day or residential camp experience for school age children and therapeutic camp for developmentally disabled or handicapped individuals and their families and for youths whose behavior is delinquent or undisciplined may be provided at county option.

Other Child Welfare Services: Social work intervention services which, in addition to core services (i.e., those services defined above that are available as Child Welfare Services) protect and promote the welfare of children, including the strengthening of their own homes where possible. Activities include gathering information about and assessing the needs and problems of a child within the context of family interaction, environment and/or coping patterns; helping a child and his family gain insights into and understanding of their needs and problems, and assisting them to know about and use other services and resources available to them. Activities also include collaborating on a case by case basis with individuals in other systems (e.g., judicial, health, education) to plan with and support a child and those involved with him through a crisis or an at-risk situation. These services may also include purchases to alleviate non-recurring, episodic events impacting the child's welfare.

In-Home Aide Services: Those paraprofessional services which assist children and adults, their families, or both with essential home management tasks, personal care tasks, or supervision, or all of the above, to enable children, adults, and their families to remain, and function effectively, in their own homes as long as possible.

• Level I Home Management - In-Home Aide Services at this level are intended to provide support to those needing assistance with basic home management tasks, such as housekeeping, cooking shopping, and bill paying. Persons/families to be served include those who are self-directing, medically stable, and have at least one instrumental activity of daily living (IADL) impairment or require assistance with basic home management tasks. Personal care tasks may not be performed at this level.

• Level II Personal Care - In-Home Aide Services at this level are intended to provide support to persons/families who predominately require assistance with basic personal care/activities of daily living but does not preclude providing assistance with home management tasks. Provision of both the personal care and home management tasks can be done for or in support of the person/family when capacities are diminishing or when he/they are striving to maintain or improve personal or family functioning. Persons/families to be served include those who are medically stable and partially dependent in activities of daily living (ADL) functioning (1 or 2 ADLs) due to physical and/or mental impairment; or who have maintenance needs and/or rehabilitative potential. In addition to their predominate personal care needs, person/families may also have increased incidental activities of daily living (IADL) needs (2-4) requiring additional support to maintain/achieve overall functioning.

• Level II Home Management - In-Home Aide Services at this level are intended to provide support to persons/families who predominately or entirely require assistance with home management tasks but does not preclude providing assistance with personal care tasks. Provision of home management tasks focuses more on strengthening and developing the person's/family's own skills than on doing these tasks for the client. Persons/families to be served include those who need assistance to remain in their own homes; to maintain, strengthen, and safeguard their functioning because of physical/emotional illness or handicap; to preserve and strengthen parental functioning; or to obtain education, training, and employment to improve their economic self-sufficiency. Persons/families may also need assistance with IADL activities to improve IADL functioning or to learn independent skills; or they may have increased IADL needs (2-4) requiring additional support to maintain/achieve overall functioning.

• Level III Home Management - In-Home Aide Services at this level are intended to provide intensive education and support to persons/families in carrying out home management tasks and improving family functioning skills. Provision of the service primarily focuses on individualized work with an individual/family in teaching and demonstrating skills and tasks and reinforcing improved individual/family accomplishments. It also involves direct assistance and support in crisis situations. Individuals/families to be served generally have moderate to severe limitations in cognitive and/or psycho-social functioning, have poor family functioning skills or are in a family crisis, but have potential for partial/total independence in IADL impairments (more than 4).

• Level III Personal Care - In-Home Aide Services at this level are intended to provide substantial ADL support to individuals/families who require assistance with health and personal care tasks. Provision of these tasks involves extensive "hands on" care and potential assistance with a wide range of health related conditions. Persons to be served include those who are medically stable with significant ADL impairments (3 or more) resulting from a chronic condition; or who are medically stable with significant ADL impairments, but have rehabilitative potential; or who are medically unstable due to recent illness, complications of a chronic condition, or a deteriorating condition with variable IADL and ADL needs; or children and their families who have any of a wide range of health related conditions and who need substantial support.

• Level IV Home Management - In-Home Aide Services at this level are intended to provide a wide range of educational and supportive services to persons/families who are in crisis or who require long term assistance with complex home management tasks and family functioning skills. Provision of the service involves quick and creative response to individual/family crisis situations identified by the case manager; it also focuses on conducting appropriate learning sessions with small groups of persons from different families who have similar needs. Persons/families to be served include those who have serious limitations in cognitive and/or psycho-social functioning, who may live in disruptive family situations, but who have the potential for major or complete independence in IADL or home management functioning and who have little or no ADL impairment.

Case Management - In-Home Services: means case management activities as defined under Case Management Services below when carried out to support and facilitate the provision of In-Home Services to a client.

Case Management means planning and directing the provision of social services within the constraints of policies and procedures to an individual who is receiving or who is applying to receive services. Activities include initial and on-going eligibility determination and assessment of the nature, impact and extent of the individual's current service needs as well as establishment of ways and means to tackle the individual's problems. This includes keeping track of what has been provided and what can be provided in relation to the client's needs. Activities include determination and orchestration of conditions and methods of service delivery, which will best support resolution of the individual's problem(s). This means assuming the role of prime agency who assures an equitable, consistent, dependable and coordinated flow of services to the client as he or she moves through the service delivery systems. Activities include establishing separate and joint responsibilities, authorities and tasks among services workers and services agencies involved in the process of helping the individual.

NOTE: When this code is used with MOE, it must only be used for non-child welfare.

Services Intake describes the function of designated service staff who are assigned to
handle the task of initiating clients into the service delivery system of the agency. Activities include receiving requests for services; exploring with the client his request in terms of the services available; taking applications; and such elements of case management as establishing eligibility for services, initiating the Service Client Information Record and certifying clients for purchased services. The extent to which Services Intake performs any of the above case management activities is an agency decision and is related to how broadly the agency wishes to define the intake function. Also included may be working with clients to apply eligibility criteria and determine eligibility for another agency's resources, e.g., crippled children, free school lunches. As a part of assessing with the client his request for help and the nature of his need, the designated intake staff may provide Information and Referral as a part of the tasks assigned to Intake.

Housing and Home Improvement Services: means assistance to individuals and families in obtaining and retaining adequate housing and basic furnishings. Services include helping to improve landlord-tenant relations, to identify sub-standard housing, to secure correction of housing code violations, to obtain or retain ownership of own home, and to find and relocate to more suitable housing. The provision of labor and materials for minor renovations and repairs to owner-occupied dwellings to remedy conditions, which are a risk to personal health and safety, may be included as an optional part of this service.

Basic appliances, such as stove, refrigerator, heater, fan, or air conditioner may also be provided at county option to facilitate the provision of housing and home improvement services. Such appliances may be provided when this is not the responsibility of the landlord and the individual lacks these essentials to prepare food or is without heat or cooling equipment, which is needed to protect their health.

Personal and Family Counseling means the rendering of counseling services or therapy to individuals, either singly or in groups, for the purpose of resolving emotional conflicts within social relationships. It operates through a process of mobilizing the strengths inherent in the family and its members to use themselves effectively in life roles and tasks. The process involves a professional relationship with a skilled counselor to help the client(s) to assess the situation, to plan steps for dealing with it, and to take appropriate action.

Individual and Family Adjustment Services means services designed to offer assistance to individuals and their family members in support of attempts to restructure or solidify the individual's environment. Activities include counseling to enable the individual to recognize, understand, and cope with problems and conflicts in regard specifically to such areas as household management, consumer affairs, family life, alcoholism, drug addiction, mental retardation, emotional disturbance, and school related problems. Such counseling is also designed to help individuals independently utilize community resources, including other social services: take advantage of natural support systems; and achieve an adequate level of functioning with the family. Also included is arranging for other services when needed to support the provision of individuals and family adjustment services; diagnostic psychological study and evaluation necessary to determine the appropriate plan of service; activities associated with fulfilling the agency's responsibility to serve as guardian or representative payee for individual clients; and social development through therapeutic groups as a part of a service plan to give individuals opportunities for participation in structured group activities focused on helping them cope with personal problems, develop capacities for more adequate social functioning and relieve social isolation.

Individual and Family Adjustment Services – Representative Payee means services offered to individuals for whom the DSS has been appointed the representative payee, including assurance of the appropriate use of income for the client's needs, and strengthening the client's basic skills in money management.

Attachment B

Annual Report on State Maintenance-of-Effort Programs: ACF-204

State: North Carolina      Fiscal Year: 2004

Date Submitted: December 17, 2004

Provide the following information for EACH PROGRAM for which the State claims MOE expenditures.

1. Name of Benefit or Service Program: Work First Emergency Cash

2. Description of the Major Program Benefits, Services, and Activities:

All counties are required to operate Emergency Assistance Programs. The procedures for determining eligibility for and providing Emergency Assistance must be described in each county's Work First Plan. Cash Assistance is provided to assist with families’ sporadic emergency needs such as a utility cut-off notice or an eviction notice.

3. Purpose(s) of Benefit or Service Program:

The State uses Work First Emergency Cash as a Benefit Service Program component to meet the statutory and regulatory TANF purpose of providing assistance to needy families so that children may be cared for in their own homes or in the homes of relatives.

4. Program Type. (Check one)

_X_ This Program is operated under the TANF program.

____ This Program is a separate State program.

5. Description of Work Activities in the SSP-MOE program (I.e., Complete only if this program is a separate State program):
N/A

6. Total State Expenditures for the Program for the Fiscal Year: $ 5,613,843

7. Total State Expenditures Claimed as MOE under the Program for the Fiscal Year:
$ 5,613,843

8. Total Number of Families Served under the Program with MOE Funds: N/A
(Note: Recipient data was unavailable for submission of this report. North Carolina will submit an amended ACF-204 if this data becomes available.)

This last figure represents (check one):

___ The average monthly total for the fiscal year.

___ The total served over the fiscal year.

9. Eligibility Criteria for Receiving MOE-funded Benefits or Services under the Program:
Maintenance of Efforts funds are used primarily to provide assistance to children. Biological or adoptive parents and step-parents may apply for assistance for a child and must be included in the payment for the family, unless they are disqualified from the program. Children are eligible for benefits through age 17. Children age 18, if in high school and expected to graduate by age 19, can receive through the month they turn 19 or graduate from high school, whichever occurs first. In order for non-custodial parents of Work First children, former Work First families, and other families with children to receive appropriate services, the family’s income must be at or below 200 percent of the federal poverty guideline.

10. Prior Program Authorization: Was this program authorized and allowable under prior law (i.e., as defined at §260.30)? (check one)

Yes _X_ No ___

11. Total Program Expenditures in FY 1995.
(NOTE: provide only if the response on to question 10 is No.)

This certifies that all families for which the State claims MOE expenditures for the fiscal year meet the State's criteria for "eligible families."

SIGNATURE:
NAME: Carmen Hooker Odom
TITLE: Secretary, North Carolina DHHS
Approved OMB No. 0970-0199 Form ACF 204, expires 6/30/2002.

Attachment B

Annual Report on State Maintenance-of-Effort Programs: ACF-204

State: North Carolina      Fiscal Year: 2004

Date Submitted: December 17, 2004

Provide the following information for EACH PROGRAM for which the State claims MOE expenditures.

1. Name of Benefit or Service Program: Non-Assistance Housing Subsidies

2. Description of the Major Program Benefits, Services, and Activities:

Rental or mortgage subsidies that are provided for fewer than 4 months, including emergency housing assistance. Housing subsidies are funded solely with MOE funds. All housing subsidies are considered a Separate State Program.

3. Purpose(s) of Benefit or Service Program:

The State uses Non-Assistance Housing Subsidies as a Benefit and Service Program component to meet the statutory and regulatory TANF purpose of providing assistance to needy families so that children may be cared for in their own homes or in the homes of relatives.

4. Program Type. (Check one)

___ This Program is operated under the TANF program.

_X_ This Program is a separate State program.

5. Description of Work Activities in the SSP-MOE program (I.e., Complete only if this program is a separate State program):

Work activities include Job Search, Job Readiness, Work Experience and On-the-Job Training.

6. Total State Expenditures for the Program for the Fiscal Year: $ 280,027

7. Total State Expenditures Claimed as MOE under the Program for the Fiscal Year: $ 280,027

8. Total Number of Families Served under the Program with MOE Funds: 434
(Note: This is an unduplicated count of individuals; family counts are not available.)

This last figure represents (check one):

___ The average monthly total for the fiscal year.

_X_ The total served over the fiscal year.

9. Eligibility Criteria for Receiving MOE-funded Benefits or Services under the Program:

Maintenance of Efforts funds are used primarily to provide assistance to children. Biological or adoptive parents and step-parents may apply for assistance for a child and must be included in the payment for the family, unless they are disqualified from the program. Children are eligible for benefits through age 17. Children age 18, if in high school and expected to graduate by age 19, can receive through the month they turn 19 or graduate from high school, whichever occurs first. In order for non-custodial parents of Work First children, former Work First families, and other families with children to receive appropriate services, the family’s income must be at or below 200 percent of the federal poverty guideline.

10. Prior Program Authorization: Was this program authorized and allowable under prior law (i.e., as defined at §260.30)? (check one)

Yes ___ No _X_

11. Total Program Expenditures in FY 1995. $ 0
(NOTE: provide only if the response on to question 10 is No.) This program did not exist in FY 1995.

This certifies that all families for which the State claims MOE expenditures for the fiscal year meet the State's criteria for "eligible families."

SIGNATURE:
NAME: Carmen Hooker Odom
TITLE: Secretary, North Carolina DHHS
Approved OMB No. 0970-0199 Form ACF 204, expires 6/30/2002.

Attachment B

Annual Report on State Maintenance-of-Effort Programs: ACF-204

State: North Carolina      Fiscal Year: 2004

Date Submitted: December 17, 2004

Provide the following information for EACH PROGRAM for which the State claims MOE expenditures.

1. Name of Benefit or Service Program: Participation Services

2. Description of the Major Program Benefits, Services, and Activities:

Includes Adult Care and other expenses necessary for participation in the Work First program. Adult Care can be provided to enable a Work First participant to complete activities outlined in the Mutual Responsibility Agreement, when the individual’s presence would otherwise be required in the home to care for the adult family member. Food services to provide nutritional meals and snacks, transportation to and from a care facility, and Adult Care Coordinator staff time may also be included.

Payment of expenses when needed to facilitate an individual's participation in approved activities may be included. Some non-component specific expenses may include car repairs, licensing fees, and meals and refreshments (as set forth in county policy). Examples of component-specific expenses include, CPR training and equipment such as a fire extinguisher for an individual providing child care for someone performing community service, and uniforms, tools, and medical exams for someone participating in work experience. One-time work related expenses are also included.

3. Purpose(s) of Benefit or Service Program:

The State uses Participation Services as a Service Program component to meet the statutory and regulatory TANF purpose of encouraging the formation and maintenance of two parent families; and .

4. Program Type. (Check one)

_X_ This Program is operated under the TANF program.

___ This Program is a separate State program.

5. Description of Work Activities in the SSP-MOE program (I.e., Complete only if this program is a separate State program):
N/A

6. Total State Expenditures for the Program for the Fiscal Year: $ 1,881,002

7. Total State Expenditures Claimed as MOE under the Program for the Fiscal Year:
$ 1,881,002

8. Total Number of Families Served under the Program with MOE Funds: 3,995
(Note: This is an estimated count of individuals obtained by applying the relative percentage of MOE expenditures to unduplicated recipient counts; family counts are not available)

This last figure represents (check one):

___ The average monthly total for the fiscal year.

_X_ The total served over the fiscal year.

9. Eligibility Criteria for Receiving MOE-funded Benefits or Services under the Program:
Maintenance of Efforts funds are used primarily to provide assistance to children.

Biological or adoptive parents and step-parents may apply for assistance for a child and must be included in the payment for the family, unless they are disqualified from the program. Children are eligible for benefits through age 17. Children age 18, if in high school and expected to graduate by age 19, can receive through the month they turn 19 or graduate from high school, whichever occurs first. In order for non-custodial parents of Work First children, former Work First families, and other families with children to receive appropriate services, the family’s income and resources must meet Eligibility Requirements as outlined in the TANF State Plan for North Carolina.

10. Prior Program Authorization: Was this program authorized and allowable under prior law (i.e., as defined at §260.30)? (check one)

Yes _X_ No ____

11. Total Program Expenditures in FY 1995.
(NOTE: provide only if the response on to question 10 is No.)

This certifies that all families for which the State claims MOE expenditures for the fiscal year meet the State's criteria for "eligible families."

SIGNATURE:
NAME: Carmen Hooker Odom
TITLE: Secretary, North Carolina DHHS
Approved OMB No. 0970-0199 Form ACF 204, expires 6/30/2002.

ACF Home | Questions? | Site Index | Contact Us | Accessibility | Privacy Policy | Freedom of Information Act | Disclaimers
Department of Health and Human Services | USA.gov: The U.S. government's official web portal

Administration for Children and Families • 370 L'Enfant Promenade, S.W. • Washington, D.C. 20447

This is a Historical Document.