The 1994 Amendments to the Social Security Act (the Act) authorize the Children's Bureau to review state child and family services programs to ensure compliance with the requirements in titles IV-B and IV-E of the Act. This includes systematic monitoring of the Title IV-E Foster Care Program, which provides funds to title IV-E agencies (states and Tribes) to assist with the costs of foster care maintenance for eligible children; administrative expenses to manage the program; and training for staff, foster parents, and certain private agency staff. Title IV-E foster care funds are awarded to the 50 States, the District of Columbia, Puerto Rico, and federally-recognized Indian Tribes, Indian Tribal organizations and Tribal consortia with approved title IV-E plans, and are available as open-ended entitlement grants through single-year appropriations. The program’s focus, which is articulated in statute, is children eligible under the pre-welfare reform Aid to Families with Dependent Children (AFDC) program and removed from their homes due to maltreatment, lack of care, lack of supervision, or other problems attributed to a relative caregiver. Specifically, the program permits title IV-E agencies to claim reimbursement for a portion of foster care expenditures for children who are removed from home and placed in foster care, and who are eligible based on the former AFDC program (in effect July 16, 1996).

In 2000, HHS published a final rule in the Federal Register to establish a new approach to monitoring state title IV-E agencies.

The Children’s Bureau conducts title IV-E foster care eligibility reviews (IV-E reviews) in accordance with 45 CFR §1356.71 to monitor the title IV-E agency’s  substantial compliance with certain requirements of title IV-E at §472(a) of the Act and implementing federal regulations at 45 CFR Parts 1355 and 1356 pertaining to:

The IV-E reviews are conducted by a team of federal and title IV-E agency representatives. The review team examines a random sample of foster care cases, provider files and payment documentation on children for whom the title IV-E agency claims reimbursement of title IV-E foster care maintenance payments. The IV-E reviews periodically monitor the title IV-E agency’s compliance in meeting title IV-E eligibility requirements; validate the accuracy of the agency’s claims for reimbursement of title IV-E payments made on behalf of children in foster care, and identify and recover improper payments.

The IV-E reviews, through a systematic evaluation of case record and payment documentation, provide a snapshot of decisions about the child’s foster care episode and, thus, the agency’s child welfare practice and fiscal accountability. As such, the IV-E reviews help to ensure fiscal accountability, improve child welfare practice and support the goals of child safety, permanency, and well-being.

During the on-site review, the review team examines child case records, including placement and payment histories, court orders, provider licensing and safety documentation, and other relevant case materials. The review team completes a Title IV-E Foster Care Eligibility On-Site Review Instrument and Instructions for each case in the review sample in which at least one IV-E foster care maintenance payment was made for a period during the 6-month period under review. The review is conducted on site during a 5-day period.

Title IV-E agencies undergo a primary review and, when necessary, a secondary review. In a primary review, a sample of 80 foster care cases is examined. A finding of four or fewer error cases allows a title IV-E agency to be found in substantial compliance with the eligibility requirements. Title IV-E agencies determined in substantial compliance based on the primary review are reviewed at 3-year intervals. If five or more cases in the primary review do not meet federal requirements, the title IV-E agency is determined not in substantial compliance. Title IV-E agencies determined no