Title IV-E Eligibility Reviews

A primary on-site review will take place with the case sample consisting of 80 cases and an oversample of 8 more cases. The sample cases will come from the Adoption Foster Care Analysis Reporting System (AFCARS) data and only include those children who are eligible for IV-E payments. Cases in the oversample will be reviewed for each of the original sample of 80 cases which are found to be in error.

After the primary review, if the total number of ineligible cases does not exceed 8, ACF will conclude that the state has an error rate less than 15% and the state will be found in substantial compliance. (For subsequent primary reviews the error rate must be less than 10% or 4 for fewer cases.) If the state is found to be in substantial compliance, another review will not take place for three years. A disallowance will be assessed on all cases, which are found to be in noncompliance for the period of time the cases are ineligible.

If the number of cases found to be in noncompliance exceeds 8, the state must develop a Program Improvement Plan (PIP). The state has 90 days to develop the plan and one year to implement the plan, unless legislation is needed. The PIP must contain: areas of noncompliance, goals and action steps, and dates for completion.

A second review will take place after completion of the PIP with the case sample being 150 cases with an oversample of 15 cases. A state will be determined to be in continued noncompliance if either the case ineligibility or dollar error rate exceeds 10%. If both the child eligibility rate and the dollar rate exceed 10%, a disallowance will be extrapolated to all IV-E funds expended during the AFCARS reporting period. For example, if Michigan is found to have a 15% error rate, this would mean a penalty of $13,350,000 per six-month period. If neither, or only one, of the error rates exceed 10%, a disallowance will be assessed for the ineligible cases for the period of time the cases are ineligible.

Requirements for review:

1. Eligibility for children who receive IV-E funding:

• Judicial determinations regarding "reasonable efforts" and "contrary to the welfare";
• The Department has responsibility for placement and care;
• Placement in a licensed foster family home or  child caring institution (CCI);
• Former Aid for Dependent Children (AFDC) eligible as of July 16, 1996.

2. Allowable payments to foster care providers who:

• Meet licensing requirements (471(a)(10));
• Criminal record checks requirements (471(a)(20));
• Are either a foster family home of an individual or a child care institution and payments are limited to those items which are included in the term "foster care maintenance payments" (472(b) and 475(4));
• "Foster family home" and "child caring institution" meet the definition in 472(c) of the Social Security Act. Michigan is in compliance with these definitions.

3. A review checklist will be used when conducting the review.

4. The child's case record must contain documentation to support the child's eligibility and payments under #1 above.

5. Eligibility of provider:

• The state must provide the licensing file for each provider which contains a licensing history, and a certificate or letter of approval for all of the following providers:
  • Public CCI with less than 25 children,
  • Private CCI,
  • Group homes, (Federal definition of a group home is "a staffed facility of 7-12 beds". Michigan's definition of  a "group home" is family foster homes with 5-6 beds.), and
  • Foster family home, including licensed relatives.
• The licensing file must contain documentation of a criminal history check.
• If the licensing file does not contain sufficient information, the state must provide information from other sources, e.g., computerized database.