1. Review of Title IV-E Waiver Opportunity
June 25, 2012

2. Agenda Waiver background Rationale for MA to apply Waiver requirements
The MA proposal
Some questions/points of discussion

3. Waiver Background

4. Key Terms
Title IV-E is a federal entitlement program that reimburses states for the maintenance costs of caring for Title IV-E eligible children (e.g. food, clothing, shelter), as well as eligible administrative costs expended by states to provide those services.  For most eligible expenditures, the federal government reimburses the Commonwealth at a rate of 50%.
Foster Care is federally defined as “24-hour substitute care for children outside their own homes.” * In this case, Foster Care includes Departmental Foster Care, Intensive Foster Care, and Congregate Care
Penetration Rate (also known as the Eligibility Rate) “represents the percentage of children in out-of-home placements for which a state received Title IV-E reimbursement from the federal government for foster care maintenance payments.”# More simply, it is the percent of Title IV-E eligible children served by the state. * #

5. History of the Waiver

6. New Waiver Opportunity
Title IV-E Waivers were authorized by the Child and Family Services Improvement and Innovation Act (2011).
Authorizes up to 10 new child welfare waiver demonstration projects in each of federal fiscal years 2012, 2013, 2014.
Each waiver can be approved up to five years with extension possibilities through September 2019.
Support innovative strategies for child welfare services by allowing flexible use of Title IV-E funds.

7. Massachusetts Waiver Process

8. Rationale for a Massachusetts Application

9. MA Foster Care Placement Population ’06-’11*
* Department of Children and Families Quarterly Reports, services/dcf/dcf-quarterly-reports.html

10. Five-Year IV-E Eligible State Foster Care Expenditures*
* Quarterly Title IV-E Claims submitted to ACF; FFY

11. Waiver Impact
The waiver offers an opportunity for revenue preservation, not revenue enhancement.
A waiver would offer Massachusetts the opportunity to obtain reimbursement for expenditures which would otherwise be ineligible for Title IV-E reimbursement, such as the state’s investment in community services.
The only way the waiver project generates this opportunity to receive reimbursement is if the waiver project reduces spending on foster care. Then, and only then, can these typically ineligible expenditures be claimed to Title IV-E for reimbursement.

12. Waiver Requirements

13. Waiver Goals per Legislation
PCG Human Services
12/9/2019
Waiver Goals per Legislation
Applicants must demonstrate that the project is designed to accomplish one or more of the following goals:
Increase permanency by reducing time in foster care and promote successful transition to adulthood for older youth
Increase positive outcomes and safety for children in their homes and communities, and improve the safety and well-being of children
Prevent child abuse and neglect and reentry into foster care

14. ACF’s Waiver Priorities*
PCG Human Services
12/9/2019
ACF’s Waiver Priorities*
ACF will give priority to projects that test or implement approaches that will:
“Produce positive well-being outcomes … with particular attention to addressing .. trauma …”
“Enhance the social and emotional well-being of children and youth who are available for adoption … or have been adopted …”
“Yield more than modest improvements … and contribute to the evidence base”
“Leverage the involvement of other resources and partners … including proposals to establish financial incentives based on achievement of positive … outcomes”
* “Finding Meaning in your Data: Strategies for Identifying a Waiver Initiative”, Children’s Bureau Data Team, May 18, 2012

15. The Massachusetts Proposal: Caring Together

16. Caring Together
Under the Caring Together initiative, four new service models will be added to DCF’s system of care for children at risk of needing, preparing to exit, or recently exited from congregate care:
Follow Along
Stepping Out
Continuum
Family Partners
The models will all provide support services and continuity of care between placement and community, to improve transitions into the community, improve placement stability, and prevent re-entry or entry to congregate care.

17. Caring Together and Waiver Goals
PCG Human Services
12/9/2019
Caring Together and Waiver Goals
Increase permanency and successful transition to adulthood
Increase positive outcomes and well-being
Prevent reentry 
Caring Together addresses all three of these goals through a suite of community-based services that will support children’s transitions to community or home, reduce reentry to care, and improve placement stability.  

18. Caring Together and Waiver Priorities
PCG Human Services
12/9/2019
Caring Together and Waiver Priorities
Caring Together:
Will be conducted in association with Massachusetts Child Trauma Project
Will enhance well-being for children and youth served under the Caring Together suite of services
Will contribute to the evidence base supported by in the Building Bridges Initiative framework
Will be jointly procured with DMH 
Positive well-being outcomes, especially addressing trauma
Focus on well-being of children available for adoption or adopted
Contribute to the child welfare evidence base
Leverage other resources and partners   

19. Discussion