Indirect/Administrative Costs This Cost Pool Includes s2

XYZ Community-Based Care, Inc.

Child Welfare Cost Allocation Plan

(Name), CEO (Street Address) (City, Florida zip)

Date

Version FY 15-16 July 1, 2015 1 XYZ Community-Based Care, Inc.

Child Welfare Cost Allocation Plan

Table of Contents Page

I. Certification

II. Background and System of Care Description

III. Accounting System Description

IV. Purpose and General Statements

V. General Approach

VI. Allocation of Cost Overview

VII. Fixed Costs with Allocated Administrative Costs

VIII. Fixed Costs with no Allocated Administrative Costs

IX. Community-Based Care Managed Costs

X. Funding Not Provided Within the DCF Community Based Care Lead Agency Contract

Attachment I – Funding Matrix

Attachment II – Organizational Chart

Attachment III – Chart of Accounts

Attachment IV - Name other attachments

Version FY 15-16 July 1, 2015 2 Section I – Certification

XYZ Community-Based Care, Inc.

Certification by Responsible Individual

I hereby certify, as the responsible official of XYZ Community-Based Care, Inc., that the following is correct to the best of my knowledge and belief:

 This Cost Allocation Plan has been developed in accordance with the requirements of Uniformed Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards (also known as the Super Circular), Code of Federal Regulations Title 2, Part 200 and is referenced hereafter as (2 CFR, Part 200). The guidance for 2 CFR, Part 200 supersedes and consolidates the requirements OMB Circulars A-21, A-87, A-110, A-122, A-89, A-102, and A-133.

 The allocation methodologies contained in this Cost Allocation Plan have been developed on the basis of a beneficial or causal relationship between the expenses incurred and the receiving organizational units or programs.

 Costs related to each activity are based on the current reporting month. All costs have been screened for allowable costs in accordance with 2 CFR, Part 200 (formally Title 2 CFR, Part 230 "Cost Principles for Non-Profit Organizations" (OMB Circular A-122).

 An adequate accounting and statistical system exists to support claims that will be made under the Cost Allocation Plan.

 The same costs that have been treated as indirect costs have not been claimed as direct costs. Similar types of cost have been accounted for on a consistent basis.

 The information provided in support of the proposed Cost Allocation Plan is accurate.

______Signature

Printed Name

Title

Date

Version FY 15-16 July 1, 2015 3 Section II – Background and System of Care Description

CBC must review and update their System of Care.

Section III – Accounting System and Description

Describe the CBC’s accounting system and complete general ledger coding structure

Also provide a description of how equipment is treated for acquisition and disposition in the CBC’s General Ledger.

Section IV – Purpose and General Statements

The purpose of this cost allocation plan is to summarize, in writing, the methods and procedures that this organization will use to allocate costs to various programs, grants, contracts and agreements.

2 CFR, Part 200 (formally Title 2 CFR, Part 230 "Cost Principles for Non-Profit Organizations" (OMB Circular A-122),” establishes the principles for determining costs of grants, contracts and other agreements with the Federal Government. XYZ Community-Based Care, Inc.’s Cost Allocation Plan is based on the Direct Allocation method described in 2 CFR, Part 200 (formally Title 2 CFR, Part 230 "Cost Principles for Non-Profit Organizations" (OMB Circular A-122). The Direct Allocation Method treats all costs as direct costs except general administration and general expenses.

Direct costs are those that can be identified specifically with a particular final cost objective. General administrative costs are those that have been incurred for common or joint objectives and cannot be readily identified with a particular final cost objective.

Version FY 15-16 July 1, 2015 4 Only costs that are allowable, in accordance with the cost principles, will be allocated to benefiting programs by XYZ Community-Based Care, Inc.

Section V – General Approach

The general approach of XYZ Community-Based Care, Inc. in allocating costs to particular grants and contracts is as follows:

A. All allowable direct costs are charged directly to program, grants, activities, or contracts. B. Allowable direct costs that can be identified to more than one program or cost pool are prorated individually as direct costs using a base most appropriate to the particular cost being prorated. C. All other allowable general and administrative costs (costs that benefit all programs and cannot be identified to a specific program) are allocated to programs, grants, contracts using a base that results in an equitable distribution as further described below.

CBC Cost Allocation Plan Requirement – In this section, the CBC should provide a description of how general costs such as rent or lease costs, telephone, supplies, insurance, legal are allocated to the various cost pools. CBCs need to disclose whether they have a federally approved indirect cost rate and if so, include as an attachment to the Cost Allocation Plan.

Section VI – Allocation of Cost Overview

The Community-Based Care (CBC) Cost Allocation Plan is presented in four sections. The first two sections encompass those expenditures that are paid for through a fixed price method and whose expenditures are managed on a statewide basis. The activities contained in the first section are clearly defined with regard to the services being offered, the clients being served, and the method by which services are being delivered. In addition, there are built-in processes that will consider costs incurred as being allowable, reasonable and necessary. All general administrative costs are allocated within this section based on the ratio of costs incurred.

The second section of the cost allocation plan reflects the cost of licensed care for maintenance. Costs recorded in this section are based on information contained in the OCA Roll Up (V2) and OCA Reconciliation (V2) Reports generated by the Florida Safe Families Network (FSFN) child welfare system.

The third section of the cost allocation plan contains the allocation of expenditures related to single fund sources. Costs captured in these cost pools are managed by the individual Community-Based Care projects. Activities described in this section are non-recurring adoption expenditures, maintenance adoption subsidies funded by Title IV-E, Chafee Foster Care Independence Program related, Chafee Education Training

Version FY 15-16 July 1, 2015 5 Voucher Program related, Medicaid Administration, State Access and Visitation Grant and Promoting Safe and Stable Families (PSSF). A portion of the costs recorded in this section are based on information contained in the OCA Roll Up (V2) and OCA Reconciliation (V2) Reports generated by the FSFN system.

The last section of the cost allocation plan describes those grants, programs, and contracts that are outside the purview of the child welfare services covered in the Community-Based Care contract. These cost pools are presented to give a complete overview of the services and activities conducted by the XYZ Community-Based Care, Inc. and the other funding sources available.

Section VII - Fixed Costs with Allocated Administrative Costs

Administrative Costs – This cost pool includes administrative or indirect costs as defined in 2 CFR, Part 200 (formally Title 2 CFR, Part 225 "Cost Principles for State, Local, and Tribal Governments" (OMB Circular A-87,) or 2 CFR, Part 200 (formally Title 2 CFR, Part 230 "Cost Principles for Non-Profit Organizations" (OMB Circular A- 122). Typical examples of costs included in this cost pool include general administrative and general expenses such as those for executive officers, personnel administration and accounting. These costs may also include items such as costs of facility maintenance and operation, and grounds maintenance.

Allocation methodology – Costs are allocated to cost pools based on their proportion of the cost to the total costs of all included cost pools. The cost pools to receive a portion of the costs in this cost pool are all of those in the fixed price section of this plan.

CBC Cost Allocation Plan Requirement – In this section, the CBC should define what types of costs are included in this cost pool and a description of how the CBC’s accounting system captures these costs. Organizational charts should be provided and referenced in the narrative to the extent feasible. Any positions with allocated costs should be fully explained as to who is being allocated, where (what cost pools) they are being allocated and the basis of allocation. Attachments may be used to simplify the explanation of allocated costs.

DCM00 - Case Management – This cost pool includes payments made to community- based care staff and / or their sub-contracted providers for in-home, out of home and adoption case management services. The services and activities may include: (a) referral to services, (b) preparation for and participation in judicial determinations, (c) placement of the child, (d) development of a case plan, (e) case reviews, (f) case management and case supervision, (g) recruitment and licensing of foster homes and institutions, (h) rate setting, (i) related agency overhead costs, (j) data collection and reporting, and (k) eligibility determination and re-determinations. The cost pool also includes court-related costs such as service of process fees, legal advertisements, court reporting, court-ordered DNA tests, expert witness fees, birth verification,

Version FY 15-16 July 1, 2015 6 background screenings and expenses for transporting clients, including Case Management positions that provide transportation of clients that could reasonably be considered as necessary for the management of the Title IV-E Case Plan for the client.

The activities for case management will meet the federal definition for these activities as the department must maintain the ability to allocate appropriately to the Title IV-E Adoption Assistance Grant. The following are examples provided in 45 CFR 1356.60(c)(2) of allowable administrative costs for the Adoption Assistance program for which federal financial participation may be claimed under Title IV-E: placement of the child in the adoptive home; case reviews conducted during a specific pre-adoptive placement for children who are legally free for adoption; case management and supervision prior to a final decree of adoption; a proportionate share of related agency overhead; and referral to services. Allowable administrative costs do not include costs of social services provided to the child, the child’s family or foster family which provides counseling or treatment to ameliorate or remedy personal problems, behaviors or home conditions.

Allocation methodology - Costs are first allocated to In-Home (including Out of Home TANF Related/Relative Caregiver), Licensed Out of Home Care and Adoption services based on statewide client counts contained in FSFN. In order to equalize the work effort among the client groups, the department has researched and established weighting factors that are based on Child Welfare League of America national studies. These weights are as follows:

 In-Home – actual client count divided by 3.04875  Licensed Out of Home Care – actual client counts divided by 1.04375  Adoption – based on actual client count

In-Home costs are further allocated between TANF Eligible and TANF Ineligible based on statewide In-Home Eligibility statistics generated from FSFN client counts. Costs are then charged in accordance with the funding matrix included as Attachment I.

Licensed Out of Home Care costs are charged in accordance with the funding matrix included as Attachment I.

Adoption costs are further allocated to Title IV-E Eligible, TANF and Ineligible based on statewide Adoption Eligibility statistics generated from FSFN client counts. Costs are then charged in accordance with the funding matrix included as Attachment I.

CBC Cost Allocation Plan Requirement – In this section, the CBC should provide a description as to how these services are provided including an indication as to whether they are provided by CBC staff or sub-contracted agencies (or both), an organizational chart, anticipated number of case managers carrying a caseload, anticipated average caseload per manager, anticipated staff to supervisor ratios, other types of staff who will be included in the cost pool, and other types of costs that are charged to the cost pool. In addition, the CBC should provide a description as to how

Version FY 15-16 July 1, 2015 7 the CBC ensures that only eligible costs are charged to this cost pool and how their accounting system captures these costs. If the case management staff also performs Prevention Services activities, there must be a description of how the CBC will allocate the cost of that staff between this cost pool and the Prevention Services for Families Currently not Dependent cost pool.

CHPA0 – Child Placing Agency – Foster Care, Group Care, or Other - This cost pool includes direct payments made to any person, corporation, or agency, public or private, other than the parent or legal guardian of the child or an intermediary acting pursuant to Chapter 63, Florida Statutes, that receives a child for placement and places or arranges for the placement of a child in a family foster home, residential child caring agency, or approved adoptive home and provides any of the necessary adoptive services listed under the definition of Adoption subsection 65C-15.001(1), Florida Administrative Code. [Rule 65C-15.001(5), Florida Administrative Code; Child- Placing Agencies].

For the purposes of this cost pool, only child-placing activities related to placing a child in a family foster home or child caring institution shall be included here. Each direct payment made shall be associated with the child being placed as the benefactor of such service.

Additional guidance for child placing agencies may be found within Chapter 65C-15, Florida Administrative Code.

Allocation methodology: Costs are first allocated to In-Home (including Out of Home TANF Related/Relative Caregiver), Licensed Out of Home Care and Adoption services based on statewide client counts contained in FSFN. In order to equalize the work effort among the client groups, the department has researched and established weighting factors that are based on Child Welfare League of America national studies. These weights are as follows:

 In-Home – actual client count divided by 3.04875  Licensed Out of Home Care – actual client counts divided by 1.04375  Adoption – based on actual client count

Licensed Out of Home Care costs are charged in accordance with the funding matrix included as Attachment I.

Version FY 15-16 July 1, 2015 8 CBC Cost Allocation Plan Requirement – In this section, the CBC should provide a description as to how these services are provided including an indication as to whether they are provided by CBC staff or sub-contracted agencies (or both), an organizational chart, other types of staff who will be included in the cost pool, and other types of costs that are charged to the cost pool. In addition, the CBC should provide a description as to how the CBC ensures that only eligible costs are charged to this cost pool and how their accounting system captures these costs.

AS000 - Adoption Services – This cost pool includes payments to community-based care staff and / or their sub-contracted providers to provide direct support to the case management staff who have clients with a goal of adoption. In addition, providers may recruit prospective adoptive parents, perform home studies, and support adoptive homes.

Allocation methodology - Adoption costs are allocated to Title IV-E Eligible, TANF and Ineligible based on statewide Adoption Eligibility statistics generated from FSFN client counts. Costs are then charged in accordance with the funding matrix included as Attachment I.

CBC Cost Allocation Plan Requirement – In this section, the CBC should provide a description as to how these services are provided including an indication as to whether they are provided by CBC staff or sub-contracted agencies (or both), an organizational chart, other types of staff who will be included in the cost pool, and other types of costs that are charged to the cost pool. In addition, the CBC should provide a description as to how the CBC ensures that only eligible costs are charged to this cost pool and how their accounting system captures these costs.

AS0CS - Adoption Support Services – Direct Client Services - This cost pool includes direct payments made to any person, corporation, or agency, public or private, other than the parent or legal guardian of the child or an intermediary acting pursuant to Chapter 63, Florida Statutes, that receives a child for placement and places or arranges for the placement of a child in a family foster home, residential child caring agency, or approved adoptive home and provides any of the necessary adoptive services listed under the definition of Adoption subsection 65C-15.001(1), Florida Administrative Code. [Rule 65C-15.001(5), Florida Administrative Code; Child- Placing Agencies]

For the purposes of this cost pool, only child-placing activities related to adoption services shall be included here. Each direct payment made shall be associated with the child being placed as the benefactor of such service. Additional guidance for child placing agencies may be found within Chapter 65C-15, Florida Administrative Code.

Version FY 15-16 July 1, 2015 9 In addition, these adoption services also include home studies and post-adoptive evaluations, and any direct payment made shall be associated with the child, either pre-adoptive or post-adoptive, as the benefactor of such service.

CBC Cost Allocation Plan Requirement – In this section, the CBC should provide a description as to how these services are provided including an indication as to whether they are provided by CBC staff or sub-contracted agencies (or both), an organizational chart, other types of staff who will be included in the cost pool, and other types of costs that are charged to the cost pool. In addition, the CBC should provide a description as to how the CBC ensures that only eligible costs are charged to this cost pool and how their accounting system captures these costs.

PVS00 - Prevention Services for Families Currently not Dependent – This cost pool includes payments to community-based care staff and / or their sub-contracted providers for secondary and tertiary prevention services to children and their families to either prevent removal of children from their household or to prevent or mitigate the possibility of a child being abused, neglected or abandoned and to prevent entry into the child welfare system. Costs may include those for staff providing services as well as purchased services. Services may include, but are not limited to, assessments, counseling, transportation, home maintenance, child care, respite, legal services, housekeeping, temporary housing and information and referral.

Secondary prevention services are targeted services provided to families with multiple risk factors prior to the occurrence of child abuse, neglect or abandonment.

Tertiary prevention services are targeted services provided to families after incidences of abuse, neglect or abandonment have occurred. The intent of services is to prevent a reoccurrence of any maltreatment.

Allocation methodology - Costs are allocated to TANF eligible and TANF ineligible based on statewide in-home eligibility from the FSFN system. Costs are then charged in accordance with the funding matrix included as Attachment I.

CBC Cost Allocation Plan Requirement – In this section, the CBC should provide a description as to how these services are provided including an indication as to whether they are provided by CBC staff or sub-contracted agencies (or both), an organizational chart, and a description of the types of costs that are charged to the cost pool. In addition, the CBC should provide a description as to how the CBC ensures that only eligible costs are charged to this cost pool and how their accounting system captures these costs.

Version FY 15-16 July 1, 2015 10 PVSCS - Prevention Services – Non-Dependent Child – This cost pool includes direct payments for services provided to In-Home non-dependency children. Such services are provided to children and their families to either prevent removal of the children from the household or to prevent or mitigate the possibility of a child being abused, neglected, or abandoned.

In addition, services are provided to In-Home non-dependency children, where verified findings of maltreatment have occurred in the past, in an effort to prevent any maltreatment from occurring again.

These service costs may include Assessment and Evaluation, Child Care, Counseling, Home Maintenance, Housekeeping, Information and Referrals, Legal Services, Respite, Temporary Housing and Transportation.

Each direct payment made shall be associated with the child as the benefactor of such service.

In-Home non-dependency clients are those families and households in which the child is not under the State’s and/or court ordered supervision.

CBC Cost Allocation Plan Requirement – In this section, the CBC should provide a description as to how these services are provided including an indication as to whether they are provided by CBC staff or sub-contracted agencies (or both), an organizational chart, and a description of the types of costs that are charged to the cost pool. In addition, the CBC should provide a description as to how the CBC ensures that only eligible costs are charged to this cost pool and how their accounting system captures these costs.

CS0IH - Other Client Services - In Home – This cost pool captures the costs of direct payments for services for in home dependency clients. Such services are provided to children and their families to prevent the child from entering the child welfare system, as well as to provide services for children and their families who are returning to their home from being in an out-of-home placement to ensure the safety of the child can and will be maintained. These costs may include Assessment and Evaluation, Counseling, Transportation, Home Maintenance, Child Care, Respite, In Home Family Support, Legal Services, Housekeeping, Information & Referral, Post Placement services, Post Placement Services and Temporary Housing.

Each direct payment made shall be associated with the child as the benefactor of such service.

Version FY 15-16 July 1, 2015 11 In-Home dependency clients are those families or households in which the child is under the State’s and/or court ordered supervision.

Allocation methodology – Costs are charged in accordance with the funding matrix included as Attachment I.

CBC Cost Allocation Plan Requirement – The CBC will provide a description of the types of costs that will be charged to this cost pool and how their accounting system captures these costs.

CS00H - Other Client Services – Out-of-Home – This cost pool is for direct payments for services to out of home dependency clients which are not allowable as foster care maintenance payments. Types of expenses include Assessment and Evaluation, Counseling, , Home Maintenance, Child Care (This would be child care costs to facilitate a foster parent’s participation in activities that are within the realm of “ordinary parental duties” or child care activities that are deemed a social service and are not reimbursable under title IV-E, such as illness of a foster parent, respite care, special needs of a child in foster care best met in a day care setting, i.e. therapeutic child care) [Administration for Children and Families, Child Welfare Policy Manual 8.3B.1-3.], Respite, In Home Family Support, Legal Services, Housekeeping, Information & Referral, Visitation, Temporary Housing and Transportation (This would be transportation outside the reasonable travel to the child’s home for visitation and reasonable travel for the child to remain in the school in which the child is enrolled at the time of placement) [Administration for Children and Families, Child Welfare Policy Manual 8.3B.1-2.].

Each direct payment made shall be associated with the child as the benefactor of such service.

NOTE: Any Medicaid eligible services must be billed to Medicaid if the client is eligible, such as the Comprehensive Behavioral Health Assessment (CBHA).

In addition, costs associated with restitution to a foster parent for damages caused by a child in foster care are allowable in this cost pool.

Allocation methodology – Costs are charged in accordance with the funding matrix included as Attachment I.

CBC Cost Allocation Plan Requirement – The CBC will provide a description of the types of costs that will be charged to this cost pool and how their accounting system captures these costs.

CS0AS - Other Client Services - Adoption – This cost pool captures the costs of direct payments for services provided to Pre-Adoption and Post-Adoption clients.

Version FY 15-16 July 1, 2015 12 Types of expenses include Assessment and Evaluation, Counseling, Transportation, Home Maintenance, Child Care, Respite, In Home Family Support, Legal Services, Housekeeping, Information & Referral, Post Placement Services and Temporary Housing.

Each direct payment made shall be associated with the child as the benefactor of such service.

Allocation methodology – Costs are charged in accordance with the funding matrix included as Attachment I.

CBC Cost Allocation Plan Requirement – The CBC will provide a description of the types of costs that will be charged to this cost pool and how their accounting system captures these costs.

PR024 - Other - This cost pool captures the cost associated with expenditures for staff cellular telephone allowances, contracts requiring deferred payments and maintenance agreements, security deposits for office leases, related professional membership dues other than personal professional membership dues, promotional materials, grant writing services, food and refreshments for clients in care of the agency or foster parents, adoptive parents and caseworkers during training sessions, and other items eligible for State funds reimbursement, but not for Federal reimbursement.

Allocation methodology – Costs are charged in accordance with the funding matrix included as Attachment I.

CBC Cost Allocation Plan Requirement – The CBC will provide a description of the types of costs that will be charged to this cost pool and how their accounting system captures these costs.

Section VIII - Fixed Costs with No Allocated Administrations

CBC Cost Allocation Plan Requirement – In this section where there are references to services that are recorded in the FSFN system, the CBC should provide a description as to how they ensure that only eligible costs are entered into FSFN and how the CBC’s accounting system interfaces with FSFN. In addition, a brief description of the reconciliation process between the CBC’s accounting system and FSFN should be provided.

Licensed Care Room and Board

LCFH0 – Licensed Care Foster Home Payments – Captures cost of providing direct payments, as recorded in FSFN, to a foster family home for children, licensed by the State in which it is situated or has been approved, by

Version FY 15-16 July 1, 2015 13 the agency of such State having responsibility for licensing homes of this type, as meeting the standards established for such licensing. [42 U.S.C. § 672(c)] These direct “foster care maintenance payments” are to cover the cost of (and the cost of providing) food, clothing, shelter, daily supervision, school supplies, a child’s personal incidentals, liability insurance with respect to a child, reasonable travel to the child’s home for visitation, and reasonable travel for the child to remain in the school in which the child is enrolled at the time of placement. [42 U.S.C. § 675(4)(A)]

Note: If the child placed in a foster family home is the parent of a son or daughter who is in the same home and payments described in Section 475(4) (A) of the Social Security Act are being made under this part with respect to such child, the foster care maintenance payments shall also include such amounts as may be necessary to cover the cost of the items described in Section 475(4)(A) of the Social Security Act, with respect to such son or daughter. [42 U.S.C. § 675(4)(A)]

A “child’s personal incidentals” are typically purchased for the child on an occasional, as-needed basis and may include a variety of items. Examples of some “personal incidentals” include:

. Cosmetics;

. Fees related to activities, such as Boy/Girl Scouts;

. Funeral expenses;

. Graduation fees;

. Infant and toddler supplies, including high chairs and diapers;

. Items related to personal hygiene;

. Miscellaneous items, such as stamps, envelopes, writing paper, film and the cost of film development for a personal camera;

. Over-the-counter medications and special dietary foods; and

. Special lessons, including horseback riding.

[Administration for Children & Families, Child Welfare Policy Manual 8.3B.1-9]

Costs are charged in accordance with the funding matrix included as Attachment I.

LCRGE – Licensed Care for Residential Group Care/Emergency Shelter Care – Captures cost of providing direct payments, as recorded in FSFN, to a

Version FY 15-16 July 1, 2015 14 private or public child-care institution that accommodates no more than twenty- five (25) children and is licensed by the State in which it is situated or has been approved by the agency of such State having responsibility for licensing homes of this type as meeting the standards established for such licensing…. [42 U.S.C. § 672(c)] These direct “foster care maintenance payments” are to cover the cost of (and the cost of providing) food, clothing, shelter, daily supervision, school supplies, a child’s personal incidentals, liability insurance with respect to a child, reasonable travel to the child’s home for visitation, and reasonable travel for the child to remain in the school in which the child is enrolled at the time of placement. [42 U.S.C. § 675(4)(A)]

Note: If the child placed in a child-care institution is the parent of a son or daughter who is in the same home and payments described in Section 475(4) (A) of the Social Security Act are being made under this part with respect to such child, the foster care maintenance payments shall also include such amounts as may be necessary to cover the cost of the items described in Section 475(4)(A) of the Social Security Act, with respect to such son or daughter. [42 U.S.C. § 675(4)(A)]

For the purposes of this cost pool and for AFCARS reporting purposes, “Group Homes” are described as child-care institutions, which are substitute care settings that house twelve (12) or fewer children. [Administration for Children and Families, Child Welfare Policy Manual 1.2B.7-6]

A “child’s personal incidentals” are typically purchased for the child on an occasional, as-needed basis and may include a variety of items. Examples of some “personal incidentals” include:

. Cosmetics;

. Fees related to activities, such as Boy/Girl Scouts;

. Funeral expenses;

. Graduation fees;

. Infant and toddler supplies, including high chairs and diapers;

. Items related to personal hygiene;

Version FY 15-16 July 1, 2015 15 . Miscellaneous items, such as stamps, envelopes, writing paper, film and the cost of film development for a personal camera;

. Over-the-counter medications and special dietary foods; and

. Special lessons, including horseback riding.

[Administration for Children & Families, Child Welfare Policy Manual 8.3B.1-9]

Costs are charged in accordance with the funding matrix included as Attachment I.

LC0TH – Licensed Care Other {Effective January 1, 2014, this title is changing to Other Licensed Care.} - Captures direct payments, as recorded in FSFN, to a private or public child-care institution that accommodates no more than twenty-five (25) children and is licensed by the State in which it is situated or has been approved by the agency of such State having responsibility for licensing homes of this type as meeting the standards established for such licensing…. [42 U.S.C. § 672(c)] These direct “foster care maintenance payments” are to cover the cost of (and the cost of providing) food, clothing, shelter, daily supervision, school supplies, a child’s personal incidentals, liability insurance with respect to a child, reasonable travel to the child’s home for visitation, and reasonable travel for the child to remain in the school in which the child is enrolled at the time of placement. [42 U.S.C. § 675(4)(A)] Costs are charged in accordance with the funding matrix included as Attachment I.

Please Note: If the child placed in a child-care institution is the parent of a son or daughter who is in the same home and payments described in Section 475(4)(A) of the Social Security Act are being made under this part with respect to such child, the foster care maintenance payments shall also include such amounts as may be necessary to cover the cost of the items described in Section 475(4)(A) of the Social Security Act, with respect to such son or daughter. [42 U.S.C. § 675(4)(A)]

For the purposes of this cost pool and for AFCARS reporting purposes, “Institutions” are described as child-care institutions, which are substitute care settings that provide care for more than twelve (12) children. [Administration for Children and Families, Child Welfare Policy Manual 1.2B.7-6]

A “child’s personal incidentals” are typically purchased for the child on an occasional, as-needed basis and may include a variety of items. Examples of some “personal incidentals” include:

. Cosmetics;

. Fees related to activities, such as Boy/Girl Scouts;

Version FY 15-16 July 1, 2015 16 . Funeral expenses;

. Graduation fees;

. Infant and toddler supplies, including high chairs and diapers;

. Items related to personal hygiene;

. Miscellaneous items, such as stamps, envelopes, writing paper, film and the cost of film development for a personal camera;

. Over-the-counter medications and special dietary foods; and

. Special lessons, including horseback riding.

[Administration for Children & Families, Child Welfare Policy Manual 8.3B.1-9]

SEC00 – Services for Sexually Exploited Children - This cost pool captures the costs of support services for children who are victims of sexual exploitation and have been adjudicated dependent or are subject to an open investigation due to allegations of abuse, neglect or exploitation.

Allocation methodology: – Costs are charged in accordance with the funding matrix included as Attachment I.

CBC Cost Allocation Plan Requirement – The CBC will provide a description of the types of costs that will be charged to this cost pool and how their accounting system captures these costs.

Section IX – Community-Based Care Managed Costs

Non-Recurring Adoption Expenses and Adoption Subsidies – are direct payments, recorded in FSFN, to the adoptive parents as a result of an adoption assistance agreement (as defined in Section 475(a)(3) of the Social Security Act) entered into by a State with parents who adopt a child with special needs.

The State:

Version FY 15-16 July 1, 2015 17  Shall make payments of nonrecurring adoption expenses incurred by or on behalf of such parents in connection with the adoption of such child, directly through the State agency or through another public or nonprofit private agency, in amounts determined under Section 475(a)(3) of the Social Security Act, and  In any case where the child meets the requirements of Section 475(a)(2) of the Social Security Act, may make adoption assistance payments to such parents, directly through the State agency or through another public or nonprofit private agency, in amounts so determined. [Section 475(a)(1)(B) of the Social Security Act]

Please Note: The nonrecurring adoption expenses shall not exceed $1,000 per adoptive child for that particular adoptive placement.

Non-Recurring Adoption Expenses

MP000 – Non-Recurring Adoption Expenses for Special Needs Children – Captures costs of payments, as recorded in FSFN, for non-recurring adoption expenses such as adoption fees, court costs, attorney fees, and other expenses which directly relate to the legal adoption of any child with special needs and which are not incurred in violation of state or Federal laws. Costs are charged in accordance with the funding matrix included as Attachment I.

Adoption Subsidies

WR001 – Title IV-E Adoption Subsidies - Captures costs of adoption assistance subsidies, as recorded in FSFN, for those clients who meet Title IV- E eligibility requirements. Costs are charged in accordance with the funding matrix included as Attachment I.

39MAS – TANF Adoption Subsidies - Captures costs of adoption assistance subsidies, as recorded in FSFN, for those clients who do not meet the Title IV-E eligibility requirements, but have been determined as eligible for TANF. Costs are charged in accordance with the funding matrix included as Attachment I.

WO006 – Child Welfare Adoption Subsidies – Captures costs of adoption assistance subsidies, as recorded in FSFN, for those clients who are not eligible for Title IV-E or TANF. Costs are charged in accordance with the funding matrix included as Attachment I.

KRCME – Case Management Extended Foster Care – This cost pool captures the costs of the salaries and expenses for community-based care staff and their sub- contracted providers’ certified case managers providing case management to Extended Foster Care clients ages 18, 19, and 20, or 21 with a disability.

Version FY 15-16 July 1, 2015 18 Allocation methodology – Costs are charged in accordance with the funding matrix included as Attachment I.

KRE00 – Chafee Case Coordination – Eligible – This cost pool captures the costs of the salaries and expenses for community-based care staff and their sub-contracted providers’ staff providing case coordination/management to the clients that are eligible for the Chafee Foster Care Independence Grant. These eligible clients are youth in foster care ages 13 – 17, and young adults that have aged out of foster care ages 18, 19, and 20.

Allocation methodology – Costs are charged in accordance with the funding matrix included as Attachment I.

KRI00 – Chafee Case Coordination – Ineligible – This cost pool is used to capture the costs of the salaries and expenses for community-based care staff and their subcontracted providers’ staff providing case coordination/management to the clients that are ineligible for the Chafee Foster Care Independence Grant. These ineligible Chafee clients are former foster care youth ages 21 and 22.

Allocation methodology – Costs are charged in accordance with the funding matrix included as Attachment I.

Version FY 15-16 July 1, 2015 19 SFSBR – Supplemental Board Rate – This cost pool captures the cost, as recorded in FSFN, of the supplemental board direct payments made to a foster family home for children, licensed by the State in which it is situated or has been approved by the agency of such State having responsibility for licensing homes of this type, as meeting the standards established for such licensing. [42 U.S.C. § 672(c)]

This is a supplemental board payment to the licensed family foster home for children, ages 13 through 17, placed in the licensed family foster home’s care for the purpose of providing independent life skills and normalcy supports. The supplemental payment shall be paid monthly to the foster care parents on a per-child basis in addition to the current monthly room and board rate payment. The supplemental monthly payment shall be based on 10 percent of the monthly room and board rate for children 13 through 21 years of age, as provided under this section and adjusted annually.

The supplemental board rate paid to foster parents is effective January 1, 2014.

CBC Cost Allocation Plan Requirement – The CBC will provide a description of the types of costs that will be charged to this cost pool and how their accounting system captures these costs.

KRLE0 – Chafee Pre-Independent Living and Life Skills Services Eligible – This cost pool captures the cost of the Independent Living Program’s pre-independent living services and life skills services that are eligible for the Chafee Foster Care Independent Grant. These eligible Chafee clients are the youth in foster care that are between the ages of 13 – 17 years old or former foster care young adults ages 18 up to their 21st birthday.

Effective October 1, 2001, services may be provided to youth ages 13 up to their 21 st birthday that are currently in or aged out of foster care to facilitate successful transition into adulthood. Examples of these services are:

Pre-independent living services - include, but are not limited to, life skills training, educational field trips, preparation for post-secondary training and education, and conferences.

Life skills services - include, but are not limited to, independent living skills training, including training to develop banking and budgeting skills, interviewing skills, parenting skills, educational support, substance abuse prevention, and employment training.

Other services that may be provided include, but are not limited to, assistance in obtaining a high school diploma, career exploration, job placement and retention, counseling, mentors, and developing community resources.

Version FY 15-16 July 1, 2015 20 This cost pool should not be used to capture the costs of children in care (maintenance payments) or direct payments made to youth/young adults in the Independent Living Program (Subsidized Independent Living (SIL), Aftercare Support Services, Transitional Support Services, and/or Road to Independence).

Allocation methodology – Costs are charged in accordance with the funding matrix included as Attachment I.

CBC Cost Allocation Plan Requirement – The CBC will provide a description of the types of costs that will be charged to this cost pool and how their accounting system captures these costs.

KRLI0 – Chafee Pre-Independent Living and Life Skills Services Ineligible – This cost pool captures the costs of the Independent Living Program’s life skill services for former foster care young adults that are ineligible for the Chafee Foster Care Independence Grant. These ineligible Chafee clients are former foster care youth ages 21 up to 23.

Life skills services include, but are not limited to, independent living skills training, including training to develop banking and budgeting skills, interviewing skills, parenting skills, time management or organizational skills, educational support, substance abuse prevention, preventive health education, and employment training.

This cost pool should not be used to capture the costs of children in care (maintenance payments) or direct payments made to youth/young adults in the Independent Living Program (Subsidized Independent Living (SIL), Aftercare Support Services, Transitional Support Services, and/or Road to Independence).

Allocation methodology – Costs are charged in accordance with the funding matrix included as Attachment I.

CBC Cost Allocation Plan Requirement – The CBC will provide a description of the types of costs that will be charged to this cost pool and how their accounting system captures these costs.

Direct Services to 18 – 22 Year Olds as Recorded in FSFN

Independent Living Program / Road to Independence - {Remains effective for service dates through December 31, 2018}

Version FY 15-16 July 1, 2015 21 In order to maximize the use of funds in the Chafee Educational and Training Voucher program, the Community-Based Care project will review its Road to Independence clients each July 1. Those clients meeting the criteria for Chafee ETV funds will be coded to charge against those funds. Once the federal cap of $5,000 ($6,250 total) is reached, these clients will be recoded as state funded clients for the remainder of the fiscal year. This is because the federal regulations do not allow clients first charged to ETV to be subsequently charged to Chafee (and vice versa). Each new client that enters the program will be coded to Chafee ETV funds, if appropriate, and subsequently moved to be funded with state funds if the funding cap is reached during the year.

CHFSS – Road To Independence Program Services {Remains effective for service dates through December 31, 2018} – Captures the costs, as recorded in FSFN, for young adults ages 18, 19, and 20 eligible for the Chafee Independent Living federal funding. Costs recorded in this code are for the “Road to Independence Program,” within the Independent Living Program, which include reasonable expenditures for:

 The cost of room and board.  Educationally related expenses, such as tutoring, summer school, and/or school supplies.  Graduation expenses, such as class rings, graduations invitations, yearbook, cap and gown, and/or senior portraits.  Educational incentives, such as club fees, luggage and backpacks for graduating youths, calculators, activity fees, tuition, vocational fees, equipment and supplies, including specialized equipment (per the Americans with Disabilities Act of 1990) for youth with disabilities which includes talking computers, wrist watches, stipends for note takers during class, and other items and services needed, due to disability, in order to attend school.

Costs are charged in accordance with the funding matrix included as Attachment I.

PLEASE NOTE: The Road to Independence (RTI) stipend, provided through the Independent Living Program, will no longer become available to young adults formerly in foster care, effective January 1, 2014. A young adult currently participating in RTI will continue his or her participation until reaching the age of 23 or otherwise becoming ineligible, due to the young adult not meeting the requirements of RTI set forth prior to January 1, 2014. After January 1, 2014, there is no reinstatement option for any currently enrolled young adult in the former Road to Independence Program, due to a young adult becoming ineligible.

CBC Cost Allocation Plan Requirement – The CBC will provide a description of the types of costs that will be charged to this cost pool and how their accounting system captures these costs.

Version FY 15-16 July 1, 2015 22 ETVSS – Education and Training Vouchers Program - Scholarship {Remains effective for service dates through December 31, 2018} – Captures the costs, as recorded in FSFN, related to the Road to Independence Scholarship Program for eligible 18, 19, 20, 21, and 22 year old young adults formerly in foster care who are attending an institution of higher education on a full-time basis. Youth who were adopted from foster care at ages 16 and 17 are also eligible to receive the Chafee Education and Training Vouchers (ETV) under this OCA.

Federal Law (P.L. 107-133, Title II, Section 201) requires initial participation in the program prior to the young adult’s 21st birthday. Federal Law (Higher Education Act of 1965, Sections 102 and 472) provides the maximum amount of federal ETV funds that may be distributed to each young adult, which is $5,000 for a 12-month-period (or a total of $6,250, $5,000 federal and $1,250 State match).

Examples of appropriate expenditures by the young adults are, but not limited to, room and board (i.e., housing, food and utilities), transportation, books, special study projects, educational support equipment or supplies (i.e., computer), vocational training and tutoring/mentoring. Costs are charged in accordance with the funding matrix included as Attachment I.

CBC Cost Allocation Plan Requirement – The CBC will provide a description of the types of costs that will be charged to this cost pool and how their accounting system captures these costs.

SF0SS – State Funded Scholarships {Remains effective for service dates through December 31, 2018} – This code captures the costs, as recorded in FSFN, for young adults ages 21 and 22, which are deemed ineligible for the Federal Chafee Foster Care Independence Program Grant due to age. Costs recorded in this code are for the “Road to Independence Scholarship Program,” within the Independent Living Program, which include reasonable expenditures for:  The cost of room and board.

Version FY 15-16 July 1, 2015 23  Educationally related expenses, such as tutoring, summer school, and/or school supplies.  Graduation expenses, such as class rings, graduations invitations, yearbook, cap and gown, and/or senior portraits.  Educational incentives, such as club fees, luggage and backpacks for graduating youths, calculators, activity fees, tuition, vocational fees, equipment and supplies, including specialized equipment (per the Americans with Disabilities Act of 1990) for youth with disabilities which includes talking computers, wrist watches, stipends for note takers during class, and other items and services needed, due to disability, in order to attend school.

Costs are charged in accordance with the funding matrix included as Attachment I.

CBC Cost Allocation Plan Requirement – The CBC will provide a description of the types of costs that will be charged to this cost pool and how their accounting system captures these costs.

SFAG0 – State Funded – Adopted/Guardianship RTI {Remains effective for service dates through December 31, 2018} – This code captures the costs, as recorded in FSFN, for young adults ages 18, 19, 20, 21, and 22, which after reaching the age of 16 were adopted from foster care or placed with a court-approved dependency guardian and spent a minimum of 6 months in foster care immediately preceding such placement or adoption, for the Road to Independence Scholarship Program. These youth are deemed ineligibles for the Chafee Independent Living federal funding due to not aging out of the foster care system or Subsidized Independent Living at age 18.

Costs recorded in this code are for the “Road to Independence Scholarship Program,” within the Independent Living Program, which include reasonable expenditures for:

 The cost of room and board.  Educationally related expenses, such as tutoring, summer school, and/or school supplies.

Version FY 15-16 July 1, 2015 24  Graduation expenses, such as class rings, graduations invitations, yearbook, cap and gown, and/or senior portraits.  Educational incentives, such as club fees, luggage and backpacks for graduating youths, calculators, activity fees, tuition, vocational fees, equipment and supplies, including specialized equipment (per the Americans with Disabilities Act of 1990) for youth with disabilities which includes talking computers, wrist watches, stipends for note takers during class, and other items and services needed, due to disability, in order to attend school.

Costs are charged in accordance with the funding matrix included as Attachment I.

CBC Cost Allocation Plan Requirement – The CBC will provide a description of the types of costs that will be charged to this cost pool and how their accounting system captures these costs.

Extended Foster Care (EFC) – {Effective January 1, 2014}

As used in the EFC section, the term “child” means an individual who has not attained 21 years of age, and the term “young adult” means an individual who has attained 18 years of age, but who has not attained 21 years of age.

EFCFH – Extended Foster Care – Foster Home – Room and Board – This code captures direct payments, as recorded in FSFN, to a foster family home for young adults, ages 18, 19, and 20, or 21 with a disability, in extended foster care. These family foster homes are licensed by the State in which it is situated or has been approved by the agency of such State having responsibility for licensing homes of this type, as meeting the standards established for such licensing. [42 U.S.C. § 672(c)]

These payments are for “Room and Board” expenses, which include:

Version FY 15-16 July 1, 2015 25 . Deposits for housing and utilities;

. Safe housing;

. Sufficient food to meet the young adult’s nutritional requirements; and

. Utilities, including electricity, gas, water, and garbage collection.

Young adults, ages 18, 19, and 20, or 21 with a disability, who are in extended foster care, reside in a licensed foster home, and are:

. Completing secondary education or program leading to an equivalent credential;

. Enrolled in an institution that provides postsecondary or vocational education;

. Participating in a program or activity designed to promote or eliminate barriers to employment;

. Employed for at least 80 hours per month; or

. Unable to participate in programs or activities listed above full time due to a physical, intellectual, emotional, or psychiatric condition that limits participation. Any such barrier to participation must be supported by documentation in the child’s case file or school or medical records of a physical, intellectual, or psychiatric condition that impairs the child’s ability to perform one or more life activities.

CBC Cost Allocation Plan Requirement – The CBC will provide a description of the types of costs that will be charged to this cost pool and how their accounting system captures these costs.

EFCGH – Extended Foster Care – Group Home – Room and Board - This code captures direct payments, as recorded in FSFN, to a private or public child-care institution which accommodates no more than twenty-five (25) children, for young adults in extended foster care, ages 18, 19, and 20, or 21 with a disability. These private or public child-care institutions are licensed by the State in which it is situated or has been approved by the agency of such State having responsibility for licensing homes of this type, as meeting the standards established for such licensing…. [42 U.S.C. § 672(c)]

These payments are for “Room and Board” expenses, which include: . Deposits for housing and utilities;

Version FY 15-16 July 1, 2015 26 . Safe housing; . Sufficient food to meet the young adult’s nutritional requirements; and . Utilities, including electricity, gas, water, and garbage collection.

Young adults, ages 18, 19, and 20, or 21 with a disability, who are in extended foster care, reside in a licensed group home, and are: . Completing secondary education or program leading to an equivalent credential; . Enrolled in an institution that provides postsecondary or vocational education; . Participating in a program or activity designed to promote or eliminate barriers to employment; . Employed for at least 80 hours per month; or . Unable to participate in programs or activities listed above full time due to a physical, intellectual, emotional, or psychiatric condition that limits participation. Any such barrier to participation must be supported by documentation in the child’s case file or school or medical records of a physical, intellectual, or psychiatric condition that impairs the child’s ability to perform one or more life activities.

CBC Cost Allocation Plan Requirement – The CBC will provide a description of the types of costs that will be charged to this cost pool and how their accounting system captures these costs.

EFCSL – Extended Foster Care – Other Supervised Living Arrangement – Room and Board – This code captures direct payments, as recorded in FSFN, to a provider of a supervised living arrangement for young adults ages 18, 19, and 20, or 21 with a disability, in extended foster care.

These payments are for “Room and Board” expenses, which include: . Deposits for housing and utilities; . Safe housing; . Sufficient food to meet the young adult’s nutritional requirements; and . Utilities, including electricity, gas, water, and garbage collection.

Young adults, ages 18, 19, and 20, or 21 with a disability, who are in extended foster care, reside in a supervised living arrangement, and are: . Completing secondary education or program leading to an equivalent credential; . Enrolled in an institution that provides postsecondary or vocational education;

Version FY 15-16 July 1, 2015 27 . Participating in a program or activity designed to promote or eliminate barriers to employment; . Employed for at least 80 hours per month; or . Unable to participate in programs or activities listed above full time due to a physical, intellectual, emotional, or psychiatric condition that limits participation. Any such barrier to participation must be supported by documentation in the child’s case file or school or medical records of a physical, intellectual, or psychiatric condition that impairs the child’s ability to perform one or more life activities.

CBC Cost Allocation Plan Requirement – The CBC will provide a description of the types of costs that will be charged to this cost pool and how their accounting system captures these costs.

EFCOE – Extended Foster Care – Other Expenses – This code captures direct payments, as recorded in FSFN, made for expenses, other than room and board, for young adults ages 18, 19, and 20, or 21 with a disability, in extended foster care, who resides in a licensed foster home, licensed group home, or other supervised living arrangement.

These payments are for other expenses which include, but are not limited to: . Child care payments for a young adult with a child; . Counselor consultations; . Expenses related to their qualifying activity, e.g. graduation announcements, cap and gown, computer, internship or apprentice related expenses i.e. tools, business attire, etc.; . Extracurricular activities; . Job skills training; . Life skills classes, including credit management and preventive health activities; . Mental health services and substance abuse counseling; . Mentoring and tutoring; . Parenting classes; and . Transportation to and from the young adult's qualifying activities.

Young adults, ages 18, 19, and 20, or 21 with a disability, who are in extended foster care, reside in a licensed foster home, licensed group home, or other supervised living arrangement, and are: . Completing secondary education or program leading to an equivalent credential;

Version FY 15-16 July 1, 2015 28 . Enrolled in an institution that provides postsecondary or vocational education; . Participating in a program or activity designed to promote or eliminate barriers to employment; . Employed for at least 80 hours per month; or . Unable to participate in programs or activities listed above full time due to a physical, intellectual, emotional, or psychiatric condition that limits participation. Any such barrier to participation must be supported by documentation in the child’s case file or school or medical records of a physical, intellectual, or psychiatric condition that impairs the child’s ability to perform one or more life activities.

CBC Cost Allocation Plan Requirement – The CBC will provide a description of the types of costs that will be charged to this cost pool and how their accounting system captures these costs.

KRA00 – Extended Foster Care – Allowance Payment (Chafee Eligible) – This code captures direct allowance payments, as recorded in FSFN, made to the young adult, ages 18, 19, or 20, who is in extended foster care, but not receiving Postsecondary Education Services & Support. The allowance payment is to enable the young adult to experience managing money as he or she transitions from licensed care to independent living. The amount of the allowance is based on a needs assessment.

The allowance payment includes, but is not limited to, expenses such as:

. Child care expenses;

. Clothing;

. Extracurricular activities;

. Internet service;

. Personal items;

. Recreational activities;

. Nonessential transportation;

. Savings;

. Telephone; and

Version FY 15-16 July 1, 2015 29 . Vehicle related expenses.

Allocation methodology – Costs are charged in accordance with the funding matrix included as Attachment I.

CBC Cost Allocation Plan Requirement – The CBC will provide a description of the types of costs that will be charged to this cost pool and how their accounting system captures these costs.

KRAI0 – Extended Foster Care – Allowance Payment (Chafee Ineligible) – This code captures direct allowance payments, as recorded in FSFN, made to the young adult, age 21 with a disability, in extended foster care, but not receiving Postsecondary Education Services & Support. The allowance payment is to enable the young adult to experience managing money as he or she transitions from licensed care to independent living. The amount of the allowance is based on a needs assessment.

The allowance payment includes, but is not limited to, expenses such as:

. Child care expenses;

. Clothing;

. Extracurricular activities;

. Internet service;

. Personal items;

. Recreational activities;

. Nonessential transportation;

. Savings;

. Telephone; and

. Vehicle related expenses.

Allocation methodology – Costs are charged in accordance with the funding matrix included as Attachment I.

CBC Cost Allocation Plan Requirement – The CBC will provide a description of the types of costs that will be charged to this cost pool and how their accounting system captures these costs.

Version FY 15-16 July 1, 2015 30 For those young adults who are eligible and participating in both Extended Foster Care (EFC) and Road to Independence Program / Postsecondary Education Services and Support (PESS), the cost pools to use are:

EFPES – Extended Foster Care – Foster Home – Post Secondary – Room and Board – This code captures direct payments, as recorded in FSFN, to a licensed foster family home for young adults, ages 18, 19, and 20, or 21 with a disability, in extended foster care and who are eligible for the Road to Independence Program – Postsecondary Education Services & Support (PESS) completing postsecondary education or a program leading to an equivalent credential.

These payments are for “Room and Board” expenses, which include:

. Deposits for housing and utilities;

. Safe housing;

. Sufficient food to meet the young adult’s nutritional requirements; and

. Utilities, including electricity, gas, water, and garbage collection.

Young adults, ages 18, 19, and 20, or 21 with a disability, who are in extended foster care, reside in a licensed foster home, and are:

. Enrolled in an institution that provides postsecondary or vocational education; or

AND

An eligible young adult, ages 18, 19, and 20, or 21 with a disability, who:

. Was living in licensed care on his or her 18th birthday or is currently living in licensed care; or was at least 16 years of age and was adopted from

Version FY 15-16 July 1, 2015 31 foster care or placed with a court-approved dependency guardian after spending at least six (6) months in licensed care within the twelve (12) months immediately preceding such placement or adoption;

. Had spent at least six (6) months in licensed care before reaching his or her 18th birthday;

. Has earned a standard high school diploma or its equivalent pursuant to Sections 1003.428, 1003.429, 1003.43, 1003.435, or 1003.438, Florida Statutes;

. Has been admitted for enrollment as a full-time student or its equivalent in an eligible postsecondary educational institution, as provided in Section 1009.533, Florida Statutes.

NOTE: For the purposes of this section, full-time means nine (9) credit hours or the vocational equivalent. A student may enroll part-time if he or she has a recognized disability or is faced with another challenge or circumstance that would prevent full-time attendance. A student needing to enroll part-time for any reason other than having a recognized disability must get approval from his or her academic advisor;

. Has reached 18 years of age but is not yet 23 years of age;

. Has applied, with assistance from the young adult’s caregiver and the community based care lead agency, for any other grants and scholarships for which he or she may qualify;

. Has submitted a Free Application for Federal Student Aid, which is complete and error free; and

. Has signed an agreement to allow the Department and Community Based Care Lead Agency access to school records.

For a young adult who remains in foster care and is attending a postsecondary school, as provided in Section 1009.533, Florida Statutes, and continues to reside in a licensed foster home, the amount of financial assistance is the established room and board rate for foster parents. This takes the place of the payment provided for in Section 409.145(4), Florida Statutes.

A young adult is eligible to receive financial assistance during the months when enrolled in a postsecondary educational institution.

Version FY 15-16 July 1, 2015 32 CBC Cost Allocation Plan Requirement – The CBC will provide a description of the types of costs that will be charged to this cost pool and how their accounting system captures these costs.

EGPES – Extended Foster Care – Group Home – Post Secondary – Room and Board – This code captures cost for direct payments, as recorded in FSFN, to a licensed group home for young adults, ages 18, 19, and 20, or 21 with a disability, in extended foster care and who are completing postsecondary education or a program leading to an equivalent credential.

Young adults, ages 18, 19, and 20, or 21 with a disability, who are in extended foster care, reside in a licensed group home, and are: . Enrolled in an institution that provides postsecondary or vocational education; or . Unable to participate in programs or activities listed above full time due to a physical, intellectual, emotional, or psychiatric condition that limits participation. Any such barrier to participation must be supported by documentation in the child’s case file or school or medical records of a physical, intellectual, or psychiatric condition that impairs the child’s ability to perform one or more life activities.

AND

Version FY 15-16 July 1, 2015 33 . Has been admitted for enrollment as a full-time student or its equivalent in an eligible postsecondary educational institution, as provided in Section 1009.533, Florida Statutes. NOTE: For the purposes of this section, full-time means nine (9) credit hours or the vocational equivalent. A student may enroll part-time if he or she has a recognized disability or is faced with another challenge or circumstance that would prevent full-time attendance. A student needing to enroll part-time for any reason other than having a recognized disability must get approval from his or her academic advisor; . Has reached 18 years of age but is not yet 23 years of age; . Has applied, with assistance from the young adult’s caregiver and the community based care lead agency, for any other grants and scholarships for which he or she may qualify; . Has submitted a Free Application for Federal Student Aid, which is complete and error free; and . Has signed an agreement to allow the Department and Community Based Care Lead Agency access to school records.

For a young adult who remains in foster care, is attending a postsecondary school, as provided in Section 1009.533, Florida Statutes, and continues to reside in a licensed group home, the amount of financial assistance is negotiated between the Community Based Care Lead Agency and licensed group home provider.

A young adult is eligible to receive financial assistance during the months when enrolled in a postsecondary educational institution.

CBC Cost Allocation Plan Requirement – The CBC will provide a description of the types of costs that will be charged to this cost pool and how their accounting system captures these costs.

EPESO – Extended Foster Care – Postsecondary – Other Expenses – This code captures direct payments, as recorded in FSFN, made for expenses, other than room and board, for young adults ages 18, 19, and 20, or 21 with a disability, in extended foster care and who are completing postsecondary education, or a program leading to an equivalent credential. These young adults reside in a licensed foster home, licensed group home, or other supervised living arrangement.

These payments are for other expenses which include, but are not limited to: . Child care payments for a young adult with a child;

Version FY 15-16 July 1, 2015 34 . Counselor consultations; . Expenses related to their qualifying activity, e.g. graduation announcements, cap and gown, computer, internship or apprentice related expenses i.e. tools, business attire, etc.; . Extracurricular activities; . Job skills training; . Life skills classes, including credit management and preventive health activities; . Mental health services and substance abuse counseling; . Mentoring and tutoring; . Parenting classes; and . Transportation to and from the young adult's qualifying activities.

AND

Version FY 15-16 July 1, 2015 35 NOTE: For the purposes of this section, full-time means nine (9) credit hours or the vocational equivalent. A student may enroll part-time if he or she has a recognized disability or is faced with another challenge or circumstance that would prevent full-time attendance. A student needing to enroll part-time for any reason other than having a recognized disability must get approval from his or her academic advisor; . Has reached 18 years of age but is not yet 23 years of age; . Has applied, with assistance from the young adult’s caregiver and the community based care lead agency, for any other grants and scholarships for which he or she may qualify; . Has submitted a Free Application for Federal Student Aid, which is complete and error free; and . Has signed an agreement to allow the Department and Community Based Care Lead Agency access to school records.

A young adult is eligible to receive financial assistance during the months when enrolled in a postsecondary educational institution.

CBC Cost Allocation Plan Requirement – The CBC will provide a description of the types of costs that will be charged to this cost pool and how their accounting system captures these costs.

EOPES – Extended Foster Care – Other Supervised Living Arrangement – Post Secondary – Room and Board – This code captures direct payments, as recorded in FSFN, to a provider of a supervised living arrangement, for young adults ages 18, 19, and 20, or 21 with a disability, in extended foster care and who are completing postsecondary education or a program leading to an equivalent credential.

Young adults, ages 18, 19, and 20, or 21 with a disability, who are in extended foster care, reside in a supervised living arrangement, and are: . Enrolled in an institution that provides postsecondary or vocational education; . Unable to participate in programs or activities listed above full time due to a physical, intellectual, emotional, or psychiatric condition that limits

Version FY 15-16 July 1, 2015 36 participation. Any such barrier to participation must be supported by documentation in the child’s case file or school or medical records of a physical, intellectual, or psychiatric condition that impairs the child’s ability to perform one or more life activities.

AND

An eligible young adult, ages 18, 19, and 20, or 21 with a disability, who: . Was living in licensed care on his or her 18th birthday or is currently living in licensed care; or was at least 16 years of age and was adopted from foster care or placed with a court-approved dependency guardian after spending at least six (6) months in licensed care within the twelve (12) months immediately preceding such placement or adoption; . Had spent at least six (6) months in licensed care before reaching his or her 18th birthday; . Has earned a standard high school diploma or its equivalent pursuant to Sections 1003.428, 1003.429, 1003.43, 1003.435, or 1003.438, Florida Statutes; . Has been admitted for enrollment as a full-time student or its equivalent in an eligible postsecondary educational institution, as provided in Section 1009.533, Florida Statutes. NOTE: For the purposes of this section, full-time means nine (9) credit hours or the vocational equivalent. A student may enroll part-time if he or she has a recognized disability or is faced with another challenge or circumstance that would prevent full-time attendance. A student needing to enroll part-time for any reason other than having a recognized disability must get approval from his or her academic advisor; . Has reached 18 years of age but is not yet 23 years of age; . Has applied, with assistance from the young adult’s caregiver and the community based care lead agency, for any other grants and scholarships for which he or she may qualify; . Has submitted a Free Application for Federal Student Aid, which is complete and error free; and . Has signed an agreement to allow the Department and Community Based Care Lead Agency access to school records.

A young adult is eligible to receive financial assistance during the months when enrolled in a postsecondary educational institution.

CBC Cost Allocation Plan Requirement – The CBC will provide a description of the types of costs that will be charged to this cost pool and how their accounting system captures these costs.

Version FY 15-16 July 1, 2015 37 The Road to Independence Program

As used in the Road to Independence Program section, the term “young adult” means an individual who has attained 18 years of age, but who has not attained 23 years of age.

Postsecondary Education Services and Supports (PESS) – {Effective January 1, 2014}

Program Eligibility –

A young adult, age 18 up to 23, not enrolled in Extended Foster Care, who:

. Was living in licensed care on his or her 18th birthday or is currently living in licensed care; or was at least 16 years of age and was adopted from foster care or placed with a court-approved dependency guardian after spending at least six (6) months in licensed care within the twelve (12) months immediately preceding such placement or adoption;

. Had spent at least six (6) months in licensed care before reaching his or her 18th birthday;

. Has earned a standard high school diploma or its equivalent pursuant to Sections 1003.428, 1003.429, 1003.43, 1003.435, or 1003.438, Florida Statutes;

. Has been admitted for enrollment as a full-time student or its equivalent in an eligible postsecondary educational institution, as provided in Section 1009.533, Florida Statutes. NOTE: For the purposes of this section, full-time means nine (9) credit hours or the vocational equivalent. A student may enroll part-time if he or she has a recognized disability or is faced with another challenge or circumstance that would prevent full-time attendance. A student needing to enroll part-time for any reason other than having a recognized disability must get approval from his or her academic advisor;

. Has reached 18 years of age but is not yet 23 years of age;

. Has applied, with assistance from the young adult’s caregiver and the Community-Based Care Lead Agency, for any other grants and scholarships for which he or she may qualify;

. Has submitted a Free Application for Federal Student Aid, which is complete and error free; and

Version FY 15-16 July 1, 2015 38 . Has signed an agreement to allow the Department and Community- Based Care Lead Agency access to school records.

CHPES – Road to Independence Program – Postsecondary Education Services & Support (PESS) – Chafee Eligible – This code captures direct payments, as recorded in FSFN, to the young adults, ages 18, 19, and 20, and/or direct payments made to the Community-Based Care Lead Agency, with the Chafee eligible young adult being the benefactor for costs associated with room and board and educationally related expenses, such as tutoring, summer school, and/or supplies.

Payments made directly to the Community-Based Care Lead Agency are to secure housing and utilities, with the balance being paid directly to the young adult until such time the lead agency and the young adult determine that the young adult can successfully manage the full amount of the assistance.

The amount of the financial assistance for a young adult who does not remain in foster care and is attending a postsecondary school, as provided in Section 1009.533, Florida Statutes, is $1,256.

A young adult is eligible to receive financial assistance during the months when enrolled in a postsecondary educational institution.

The amount of the financial assistance may be disregarded for purposes of determining the eligibility for, or the amount of, any other federal or federally support assistance.

CBC Cost Allocation Plan Requirement – The CBC will provide a description of the types of costs that will be charged to this cost pool and how their accounting system captures these costs.

SFPES – Road to Independence Program – Postsecondary Education Services & Support (PESS) – State Funded – This code captures direct payments, as recorded in FSFN, to the young adults, ages 21 & 22, and/or direct payments made to the Community-Based Care Lead Agency, with the eligible young adult being the benefactor for costs associated with room and board and educationally related expenses, such as tutoring, summer school, and/or supplies.

Version FY 15-16 July 1, 2015 39 The amount of the financial assistance for a young adult who does not remain in foster care and is attending a postsecondary school, as provided in Section 1009.533, Florida Statutes, is $1,256.

A young adult is eligible to receive financial assistance during the months when enrolled in a postsecondary educational institution.

The amount of the financial assistance may be disregarded for purposes of determining the eligibility for, or the amount of, any other federal or federally support assistance.

Please Note: For the remainder of SFY 2013/2014, this cost pool may also be used for those young adults, ages 18, 19, and 20, who were currently in the former Independent Living Program’s RTI, received the Chafee Educational & Training Voucher federal funds during July 1, 2013 through December 31, 2013 and has met the $6,250 maximum amount. This may only be done through the reminder of SFY 2013/2014 and ends with the “Service Ending Date” of June 30, 2014.

CBC Cost Allocation Plan Requirement – The CBC will provide a description of the types of costs that will be charged to this cost pool and how their accounting system captures these costs.

ETVPS – Road to Independence Program – Postsecondary Education Services & Support (PESS) – Chafee Education & Training Voucher Program – This code captures direct payments, as recorded in FSFN, to the young adults, ages 18 up to 23, and/or direct payments made to the Community Based Care Lead Agency, with the young adult being the benefactor for costs associated with room and board and educationally related expenses, such as tutoring, summer school, and/or supplies.

Payments made directly to the Community Based Care Lead Agency are to secure housing and utilities, with the balance being paid directly to the young adult until such time the lead agency and the young adult determine that the young adult can successfully manage the full amount of the assistance.

The amount of the financial assistance for a young adult who does not remain in foster care and is attending a postsecondary school, as provided in Section 1009.533, Florida Statutes, is $1,256. A young adult is eligible to receive financial assistance during the months when enrolled in a postsecondary educational institution.

Version FY 15-16 July 1, 2015 40 The amount of the financial assistance may be disregarded for purposes of determining the eligibility for, or the amount of, any other federal or federally support assistance.

The Chafee Education & Training Voucher (ETV) Program is for eligible 18, 19, 20, 21, and 22 year old young adults, formerly in foster care, who are attending an institution of higher education, on a PART-TIME or FULL-TIME basis, as provided by federal law (Higher Education Act of 1965, Public Law, Sections 101 and 102). Note: The institution of higher education determines the number of hours required to be determined a part-time or full-time student for the purposes of the ETV program. Section 409.1451(2)(a)4., Florida Statutes, deems nine (9) credit hours “full-time” for the purposes of determining eligibility for the PESS Program ONLY.

A young adult participating on the date he or she attains 21 years of age remains eligible to continue receiving the voucher until 23 years of age, as long as he or she is enrolled in a postsecondary education or training program and is making satisfactory progress toward completion of that program. Federal law (Public Law 107-133, Title II, Section 201) requires initial participation in the program prior to the young adult's 21st birthday. Federal law (Higher Education Act of 1965, Sections 102 and 472) provides the maximum amount of ETV funds that may be distributed to each young adult, which is $6,250 ($5,000 federal share and $1,250 state match) for a 12-month period. This 12-month period follows each state fiscal year.

The amount of $6,250 may not exceed the actual cost of attendance for the postsecondary educational institution in which the young adult is enrolled. A cost of attendance assessment is required. ETV funds are to be paid directly to the young adult unless the young adult requests otherwise. These funds are to help eligible students who are former foster care children receive the educational and vocational training needed to achieve independence.

Examples of appropriate expenditures by the young adult include: . Books; . Educational support equipment/supplies (i.e. computer); . Room and board (i.e., housing, food and utilities); . Special study projects; . Tutoring/mentoring; . Transportation; and . Vocational training.

Version FY 15-16 July 1, 2015 41 PLEASE NOTE: Historically, the fund split for an ETV OCA was 80% Federal (ETV) and 20% State Match. To maximize efficiencies for the Community Based Care (CBC) Lead Agencies and to ensure the federal maximum amount per young adult in a 12-month period is not exceeded, the Department is adjusting the fund split to 20% Federal (ETV) and 80% State Match. This change will enable CBC Lead Agencies to continue with one OCA during the entire 12-month period without having to change the OCA once the young adult has exceeded the maximum federal earnings.

CBC Cost Allocation Plan Requirement – The CBC will provide a description of the types of costs that will be charged to this cost pool and how their accounting system captures these costs.

Aftercare Support Services

Effective January 1, 2014, young adults participating in the former Road-to- Independence Program, Extended Foster Care (EFC), or Postsecondary Education Services & Support (PESS) are ineligible to receive Aftercare Services.

CH0AT – Chafee Aftercare – Other – This code captures the costs, as recorded in FSFN, of services and/or support, other than room and board for young adults ages 18, 19, and 20 within the “Aftercare Support Services” provided by the Road to Independence Program and/or direct payments made to a provider, with the Chafee eligible young adult being the benefactor for costs of:

 Mentoring and tutoring.  Mental health services and substance abuse counseling.  Life skills classes, including credit management and prevention health activities.  Parenting classes.  Job skills training.  Counselor consultations.

Costs are charged in accordance with the funding matrix included as Attachment I.

PLEASE NOTE: Effective January 1, 2014, young adults participating in the former Road-to-Independence Program, Extended Foster Care (EFC), or Postsecondary Education Services & Support (PESS) are ineligible to receive Aftercare Services.

CBC Cost Allocation Plan Requirement – The CBC will provide a description of the types of costs that will be charged to this cost pool and how their accounting system captures these costs.

Version FY 15-16 July 1, 2015 42 SFSRA – State Funded Aftercare – Room and Board – This code captures the cost, as recorded in FSFN, of room and board for young adults ages 18, 19, 20, 21, and 22, within the “Aftercare Support Services” provided by the Road to Independence Program. Room and board costs include housing, food, utilities, and rental deposits.

Costs are charged in accordance with the funding matrix included as Attachment I.

CBC Cost Allocation Plan Requirement – The CBC will provide a description of the types of costs that will be charged to this cost pool and how their accounting system captures these costs.

SF0AT – State Funded Aftercare – Other – This code captures the costs, as recorded in FSFN, of services and/or support, other than room and board for young adults, ages 21 and 22, who are ineligible for the Chafee Independent Living Grant due to age, within the “Aftercare Support Services” provided by the Road to Independence Program and/or direct payments made to a provider, with the young adult being the benefactor for costs of:

Costs are charged in accordance with the funding matrix included as Attachment I.

CBC Cost Allocation Plan Requirement – The CBC will provide a description of the types of costs that will be charged to this cost pool and how their accounting system captures these costs.

Version FY 15-16 July 1, 2015 43 ETVAF – Chafee Education and Training Voucher (ETV) Program – Aftercare Services – This code captures direct payments, as recorded in FSFN, to eligible young adults, ages 18 up to 23, and/or direct payments made to a provider, as directed by the young adult, with the young adult being the benefactor for costs associated with room and board and educationally related expenses, such as tutoring, summer school, and/or supplies. Young adults must be attending a postsecondary institution, either full-time or part-time, as provided by federal law (Higher Education Act of 1965, Public Law, Sections 101 and 102).

A young adult, age 18 up to 23, is eligible for Aftercare Services, within the Road to Independence Program, if he or she was a dependent child (pursuant to Chapter 39, Florida Statutes) and had lived in licensed foster care, or in subsidized independent living, at the time of his or her 18th birthday.

Version FY 15-16 July 1, 2015 44 . Transportation; and . Vocational training.

Costs are charged in accordance with the funding matrix included as Attachment I.

CBC Cost Allocation Plan Requirement – The CBC will provide a description of the types of costs that will be charged to this cost pool and how their accounting system captures these costs.

ETVAP – Chafee Education and Training Voucher (ETV) Program – Adopted or Permanent Guardianship 16 or 17 – Non PESS or Aftercare Services – This code captures the direct payments to eligible young adults, ages 16 up to 23, and/or direct payments made to a provider, as directed by the young adult, with the young adult being the benefactor for costs associated with room and board and educationally related expenses, such as tutoring, summer school, and/or supplies. Young adults must be attending a postsecondary institution.

Please Note: This OCA should only be used for those eligible adopted or permanent guardianship court-approved young adults once it has been determined he or she is NOT eligible for Postsecondary Education Services and Support (PESS) through the Road-to-Independence Program, as provided by Section 409.1451, Florida Statutes.

Program Eligibility -

A young adult, age 16 up to 23, not receiving services through the Road-to- Independence Program, as provided by Section 409.1451, Florida Statutes, who:

. Was at least 16 years of age and was adopted from foster care or placed with a court-approved dependency guardian after spending at least six (6) months in licensed care within the twelve (12) months immediately preceding such placement or adoption;

. Has earned a standard high school diploma or its equivalent pursuant to Sections 1003.428, 1003.429, 1003.43, 1003.435, or 1003.438, Florida Statutes; and

Version FY 15-16 July 1, 2015 45 . Has been admitted for enrollment as a FULL-TIME or PART- TIME basis, as provided by federal law (Higher Education Act of 1965, Public Law, Sections 101 and 102).

The amount of $6,250 may not exceed the actual cost of attendance for the postsecondary educational institution in which the young adult is enrolled. ETV funds are to be paid directly to the young adult unless the young adult requests otherwise.

Documentation Required -

. Proof of enrollment and/or satisfactory progress;

. A fund disbursement schedule;

. Cost of attendance documentation; and

. A youth individualized budget.

CBC Cost Allocation Plan Requirement – The CBC will provide a description of the types of costs that will be charged to this cost pool and how their accounting system captures these costs.

PR005 - Medicaid Administration - This cost pool captures the cost of working with a Medicaid eligible child. This cost pool reflects time spent performing healthcare case management and referrals to medical providers, Child Health check-ups, scheduling and follow-up, and arranging for transportation (but not providing the transportation) to healthcare providers. Activities may include:

 Applying for Medicaid benefits (or providing assistance in applying).

Version FY 15-16 July 1, 2015 46  Providing healthcare case management and case supervision.  Arranging for periodic medical screening, dental assessments, and making referrals and scheduling for further diagnosis and treatment.  Coordinating and assisting with transportation (not providing) to healthcare appointments.  Completing annual re-determination of adopted child’s Title XIX eligibility through age 21.

Allocation methodology – Costs are charged in accordance with the funding matrix included as Attachment I.

CBC Cost Allocation Plan Requirement – In this section, the CBC should list all staff associated to this cost pool and define their roles, as described in the bullets above, in working with Medicaid eligible children. CBC should also describe the allocation methodology used to determine cost and reflect the effort spent performing Medicaid Administrative activities. Any positions with allocated costs should be fully explained as to who is being allocated, where (what cost pools) they are being allocated and the basis of allocation. The CBC’s Organizational chart and Position listing should be provided to identify each position and referenced, to the extent feasible, the cost pool(s) where they are being allocated. If any functions are subcontracted, identify as such and associate them with each activity performed as described in the bullets above. Also describe any allocation methodology and basis used to determine cost and effort spent performing Medicaid Administrative activities. Attachments may be used to simplify the explanation of allocated costs. In addition, the CBC will provide a description of the types of costs that will be charged to this cost pool and how their accounting system captures these costs.

PRSAV – State Access and Visitation – This cost pool captures the costs associated with the portion of the Family Visitation Program used to support and facilitate non-custodial parent access and visitation with their children.

Match of 10% is generated from local sources.

Allocation methodology - Costs are charged in accordance with the funding matrix included as Attachment I.

CBC Cost Allocation Plan Requirement – The CBC will provide a description of the types of costs that will be charged to this cost pool and how their accounting system captures these costs.

PRE04 – Safe and Stable Families – Family Preservation - This cost pool captures the cost for “family preservation services” not provided through contributions from state or local sources. These are services for children and families designed to help families (including adoptive and extended families) at risk or in crisis as defined by Title IV-B, Sub-Part 2, Social Security Act, Section 431.

Version FY 15-16 July 1, 2015 47 These services are secondary and tertiary prevention services to prevent family disruption and unnecessary removal of children from their homes. These services provide intensive involvement that may include services within the home and may include the following:

 Follow-up care to families upon child’s return to home  Temporary out-of-home placement  Respite/Crisis care services  Parenting skills services  Family budgeting skills  Coping with stress  Health  Nutrition training

These services may be provided within or outside the home of the child, be short-term (from a few hours to a few weeks) and be intended to enable the family to stay together and to keep the child living in the home and community of the child.

Match of 25% is generated from local funds.

Allocation Methodology - Costs are charged in accordance with the funding matrix included as Attachment I.

CBC Cost Allocation Plan Requirement – The CBC will provide a description of the types of costs that will be charged to this cost pool and how their accounting system captures these costs.

PRE06 – Safe and Stable Families – Family Support Services - This cost pool captures the cost for “family support services” not provided through contributions from state or local sources as defined by Title IV-B, Sub-Part 2, Social Security Act, Section 431.

These are community based services used to promote the safety and 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 safe, stable and supportive family environment and to otherwise enhance child development.

These are primary and secondary prevention services that are provided to families before abuse or neglect occurs and are not time limited. These services include the following:

 Respite/Crisis care services

Version FY 15-16 July 1, 2015 48  Early developmental screening to assess children’s needs and to assist in obtaining specific services to meet their needs  Mentoring, tutoring and health education for youth  Center-based activities (informal interactions in drop-in centers, parent support groups)  Parenting skills services  Counseling and home visiting activities

Match of 25% is generated from local funds.

Allocation Methodology - Costs are charged in accordance with the funding matrix included as Attachment I.

CBC Cost Allocation Plan Requirement – The CBC will provide a description of the types of costs that will be charged to this cost pool and how their accounting system captures these costs.

PRE11 – Safe and Stable Families –Time Limited Reunification Services - This cost pool captures the cost of “time limited family reunification services” not provided through contributions from state or local sources as defined by Title IV-B, Sub-Part 2, Social Security Act, Section 431.

The term “time-limited family reunification services” means the services and activities that are provided to a child that is removed from the child’s home and placed in a foster family home or a child care institution and to the parents or primary caregiver of that child, in order to facilitate the reunification of the child safely and appropriately within a timely fashion, but only during the 15-month period that begins on the date the child is considered to have entered foster care.

These services may include the following:

 Individual, group and family counseling  Inpatient, residential or outpatient substance abuse treatment services  Mental health services  Domestic violence assistance  Respite/Crisis services  Visitation Services

The services may be provided within or outside the home of the child, be short-term (from a few hours to a few weeks of time) and be intended to enable the family to stay together and to keep the child living in the home and community of the child.

Match of 25% is generated from local funds.

Version FY 15-16 July 1, 2015 49 Allocation Methodology - Costs are charged in accordance with the funding matrix included as Attachment I.

CBC Cost Allocation Plan Requirement – The CBC will provide a description of the types of costs that will be charged to this cost pool and how their accounting system captures these costs.

PRE12 – Safe and Stable Families – Adoption Promotion and Support Services - This cost pool captures the cost of “adoption promotion and support services” not provided through contributions from state or local sources, as defined by Title IV-B, Sub-Part 2, Social Security Act, Section 431.

The term “adoption promotion and support services” means services and activities designed to encourage more adoptions out of the foster care system, when adoptions promote the best interests of children, including such activities as pre- and post- adoptive services and activities designed to expedite the adoption process and support adoptive families. These services are designed to minimize disruption for adoptive families by providing services that may include:

 Recruitment of adoptive families through media campaigns,  Adoptive families support groups,  Individual and family counseling for adopted children and/or family members for a duration of 12 months or less,  Post-adoption workshops/seminars for adopted children and families on topics relevant to on-going issues facing adoptive families, and  Follow-up support services to adoptive families.

Match of 25% is generated from local funds.

Allocation Methodology - Costs are charged in accordance with the funding matrix included as Attachment I.

CBC Cost Allocation Plan Requirement – The CBC will provide a description of the types of costs that will be charged to this cost pool and how their accounting system captures these costs.

DCTRN – CBC Case Management Salary IV-E Training - This cost pool captures the salaries and fringe benefits of the local agencies’ Dependency Case Managers, who administer the Title IV-E state plan by providing case management services for children ages 0 through 17, for the time period the employees participate in title IV-E eligible training, including the five-week child protection professional pre-service core child welfare curriculum training, field training, and in-service training. .

Employees will select the appropriate activity type when reporting hours worked in the local agency’s Human Resources Information System.

Version FY 15-16 July 1, 2015 50 Each Community Based Care Lead Agency must submit a quarterly report providing the listing of each training participant’s name, number and specific type (pre-service, field, or in-service) of training hours, and hourly amount as documented in the local agency’s Human Resources Information System.

IV-E training topics that the State may claim at the enhanced Federal financial participation rate under section 474 (a)(3)(A) and (B) of the Social Security Act and 45 CFR 1356.60(b) must be closely related to one of the examples cited in 45 CFR 1356.60(c)(1) and (2) as allowable administrative activities under the title IV-E program. The regulatory examples of allowable activities include:  Eligibility determinations and re-determinations  Fair hearings and appeals  Rate setting  Referral to services  Preparation for and participation in judicial determinations  Placement of the child  Development of the case plan  Case reviews  Case management and supervision  Recruitment and licensing of foster homes and institutions

Additional examples of allowable administrative activities specifically application to the title IV-E adoption assistance program include, but are not limited to:  Grievance procedures  Negotiation and review of adoption assistance agreements  Post-placement management of subsidy payments  Home studies  A proportionate share of the development and use of adoption exchanges

There are many training topics that are closely related to title IV-E allowable activities that the State may train its workers on and claim at the enhanced rate. Examples of title IV-E allowable activities that the state may train its workers on and claim at the 75% rate:  Social work practice, such as family c entered practice and social work methods including interviewing and assessment  Cultural competency related to children and families  Title IV-E policies and procedures  Child abuse and neglect issues, such as the impact of child abuse and neglect on a child, and general overviews of the issues involved in child abuse and neglect investigations, if the training is not related to how to conduct an investigation of child abuse and neglect  Permanency Planning including using kinship care as a resource for children involved with the child welfare system

Version FY 15-16 July 1, 2015 51  General substance abuse, domestic violence, and mental health issues related to children and families in the child welfare system, if the training is not related to providing treatment or services  Effects of separation, grief and loss, child development, and visitation  Communication skills required to work with children and families  Activities designed to preserve, strengthen, and reunify the family, if the training is not related to provided treatment or services  Assessment to determine whether a child’s situation requires removal from the home, if the training is not related directly to conducting a child abuse and neglect investigation. Training on how to conduct specialized assessments such as psychiatric, medical or educational assessments are not permitted.  Ethics training associated with a title IV-E state plan requirement, such as the confidentiality requirements in section 471(a)(8) of the Act  Contract negotiation, monitoring, or voucher processing related to the IV-E program  Adoption and Foster Care Analysis and Reporting System (AFCARS), Statewide Automated Child Welfare Information System (SACWIS) or other child welfare automated system functionality that is closely related to allowable administrative activities in accordance with 45 CFR 1356.60(d) that the State has chosen to claim as title IV-E training rather than as SACWIS developmental or operational costs  Independent living and the issues confronting adolescents preparing for independent living consistent with section 477(b)(3)(D) of the Act and the Child Welfare Policy Manual Section 3.aH, Q/A #1.  Foster care candidate determinations and pre-placement activities directed toward reasonable efforts in 471(a)(16), if the training is not related to providing a service  Training on referrals to services, not how to perform the services

The State may not claim the title IV-E funds unless the training addresses topics closely related to one of the examples of title IV-E administrative costs listed in Federal regulation at 45 CFR 1356.60(c)(1) and (2). In addition, funds are not allowable at either the 75 or 50 percent match rate for training on topics that do not address a general administrative need that is determined necessary for the proper and efficient administration of the title IV-E program. Examples include, but are not limited to:  How to address or treat child or family problems or behaviors because it supports the delivery of social services rather than the administration of the title IV-E state plan.  Conducting child abuse and neglect investigations because such specialized skills are require for staff activities that occur prior to a child’s entering foster care or adoption, and even prior to a child’s becoming a candidate for foster care. Child welfare/social service topics that are not related directly to the title IV-E programs or the administration of the title IV-E plan.

Version FY 15-16 July 1, 2015 52 Allocation methodology: – Costs are charged in accordance with the funding matrix included as Attachment I.

CBC Cost Allocation Plan Requirement – The CBC will provide a description of the types of costs that will be charged to this cost pool and how their accounting system captures these costs.

TRCOR – CBC IV-E Training - This cost pool captures the costs of actual salaries and fringe benefits for staff development personnel assigned to training functions to the extent time is spent performing such functions and salary, fringe benefits for experts outside the agency engaged to develop or conduct training programs, and costs of space, postage, training supplies, and purchase or development of training material.

Allocation methodology: – Costs are charged in accordance with the funding matrix included as Attachment I

CBC Cost Allocation Plan Requirement – The CBC will provide a description of the types of costs that will be charged to this cost pool and how their accounting system captures these costs.

TRCIT – CBC Case Management Training Technology - This cost pool captures the costs of technology identified in a statewide training needs assessment.

Allocation methodology: – Costs are charged in accordance with the funding matrix included as Attachment I.

CBC Cost Allocation Plan Requirement – The CBC will provide a description of the types of costs that will be charged to this cost pool and how their accounting system captures these costs.

TRFCA – CBC – Training Foster and Adopt Parent - This BE/OCA combination captures the costs associated with foster parent and adoptive parent training. It is used primarily for payments to qualified trainers to conduct Model Approach to Partnerships in Parenting (MAPP) Training for foster and adoptive parents. Training includes, but is not limited to, special techniques and strategies for effectively dealing with serious behavioral problems of children, training parents to train other parents, co-training for MAPP, mentor training and positive parenting courses.

Allocation methodology: – Costs are charged in accordance with the funding matrix included as Attachment I.

Version FY 15-16 July 1, 2015 53 CBC Cost Allocation Plan Requirement – The CBC will provide a description of the types of costs that will be charged to this cost pool and how their accounting system captures these costs.

BAT00 – Protective Investigator Training – This cost pool captures the costs related to providing training for Department of Children and Families Protective Investigations staff for in-service and pre-service areas. The pre-service training consists of activities associated with child abuse and neglect reports. These activities may include assessment of child’s safety and well-being, placement of a child when safety is an issue, preparation and participation in a judicial hearing, coordination of medical, psychological, emotional services to address the needs of the child and family, development of a plan for participation, follow-up and referral services to address issues involving allegations and preventive services when out-of-home placement can be avoided. Additional in-service training will include substance abuse and mental health, ethics, FSFN, forensic interviewing, domestic violence, sexual abuse, cultural diversity and preparing for the ITR. A certification statement will be completed that documents 100% of a work day consisting of training and related activities for protective investigators.

Allocation Methodology - Costs are charged in accordance with the funding matrix included as Attachment I.

CBC Cost Allocation Plan Requirement – The CBC will provide a description of the types of costs charged to this cost pool and how its accounting system captures these costs.

19MCB – Children’s Mental Health (SED) Services (Case or Treatment Plan Specific) – This cost pool captures the cost of providing direct payments for services and supports that are not Medicaid reimbursable, to eligible children placed in Out-of- Home care, or who are at high risk for placement in Out-of-Home care, with severe emotional disturbance as defined in Section 1912(c) of the Public Health Services Act, as amended by Public Law 102-321.

Expenditure of these funds for services and supports must be in accordance with the Community Mental Health Block Grant guidelines and may be used in nontraditional ways to meet client treatment needs. Expenditures must be used solely for direct community-based services and supports, and each direct payment made shall be associated with the child as the benefactor of such service.

These community wraparound services and supports must be included as part of the child’s treatment goals in the child’s mental health treatment plan, as defined in Section 394.496, Florida Statutes, or the child welfare case plan, as described in Sections 39.6011 and 39.6012, Florida Statutes.

Version FY 15-16 July 1, 2015 54 This cost pool captures the cost of providing non-Medicaid reimbursable wraparound services to children with mental health or behavioral health needs who are victims of abuse, in the physical care or custody of the state or at high risk for out-of-home placement. The funds are used to meet the department’s MOE for the Community Mental Health Block Grant and are used for children who are diagnosed with severe emotional disturbance (SED) as defined pursuant to Section 1912(c) of the Public Health Service Act, as amended by Public Law 102-321. Specifically children: (1) from birth up to age 18 (2) who currently or at any time during the past year, have had a diagnosable mental health, behavioral or emotional disorder of sufficient duration to meet diagnostic criteria specified within DSM-IV or their ICD-9 CM equivalent (and subsequent revisions) (3) with conditions that resulted in functional impairment that substantially interferes with or limits the their role or functioning in family, school or community activities or children who would have met the functional impairment criteria during the referenced year without the benefit of treatment or other support services.

Provided services must be identified in the mental health treatment plan for the child(ren) as defined in Section 394.496, Florida Statutes, or in the case plan for the child(ren) as described in Sections 39.6011 and 9.6012, Florida Statutes.

These funds may be used in non-traditional ways to meet client treatment needs such as outings, clothing, and educational materials, etc. when they are specified in the treatment plan or case plan as part of the child’s treatment goals.

Allocation Methodology – These funds are used to purchase wraparound services and supports that are part of the child’s mental health treatment or case plan not otherwise available to these children through other funding sources, such as Medicaid. Costs are charged in accordance with the funding matrix included as Attachment I.

CBC Cost Allocation Plan Requirement – The CBC will provide a description of the types of costs that will be charged to this cost pool and how their accounting system captures these costs.

SFMVS – CBC Mentor and Volunteer Program - This cost pool captures nonrecurring costs of the Friends of Foster Children pilot program in Mentoring Children and Parents with the Children’s Network of Southwest Florida community based care lead agency.

Allocation methodology: – Costs are charged in accordance with the funding matrix included as Attachment I.

CBC Cost Allocation Plan Requirement – The CBC will provide a description of the types of costs that will be charged to this cost pool and how their accounting system captures these costs.

Version FY 15-16 July 1, 2015 55 SFTOP – CBC Teen Outreach Program - This cost pool captures nonrecurring costs of Teen Outreach program provided by the Children’s Network of Southwest Florida community based care lead agency.

Allocation methodology: – Costs are charged in accordance with the funding matrix included as Attachment I.

CBC Cost Allocation Plan Requirement – The CBC will provide a description of the types of costs that will be charged to this cost pool and how their accounting system captures these costs.

Section X – Funding Not Provided Within the DCF Community Based Care Lead Agency Contract

Prepaid Mental Health Program – This cost pool captures the costs charged to a contract with the Community-Based Care Partnership, Ltd. to provide allowable prepaid mental health services to Medicaid eligible children as described in the Agency for Health Care Administration (AHCA) Handbook. Services will include an array of inpatient/outpatient hospital services, physician services, outpatient mental health services, therapeutic group care and comprehensive behavioral health assessments. Services provided will exclude SIPP and behavioral health overlay services.

Allocation Methodology – Costs incurred are direct charged to the contract.

CBC Cost Allocation Plan Requirement – The CBC will provide a description of the types of costs charged to this cost pool and how its accounting system captures these costs.

Version FY 15-16 July 1, 2015 56 Cost Allocation Plan Attachment I

IV-E State Funding Sources Adoption TANF MOE (State) CAPTA IV-B SSBG2 SSBG Waiver (GR/TS/OM/CW)

Case Management / Child Placing Agencies IH-TANF X X X IH- Ineligible X X Out of Home Care X X X Adoption IV-E X Adoption – TANF X X Adoption – Ineligible X

Adoption Services Adoption IV-E X Adoption – TANF X X Adoption – Ineligible X

Prevention Services for Families not Dependent TANF Allowable X X X X X TANF Non-Allowable X X

Other Client Services for Out-of-Home, In-Home(Dependent Child), and Adoption Eligible X

CBC Services for Sexually Exploited Children (SEC00) Eligible X

Other Services Eligible X

Licensed Care – All Eligible X X X

Non-Recurring Adoption Expenses Adoption IV-E X

Adoption Subsidies Adoption - IV-E X Adoption – TANF X X Adoption – Ineligible X

Version FY 15-16 July 1, 2015 57 Attachment I Safe and State MOE (State) IV-E Adoption Funding Sources Chafee ETV Medicaid State Access Stable Families (GR/TS/OM/CW) Admin Visitation Act

Independent Living Program and Road to Independence Program Chafee Administration Eligible X X Ineligible X

Independent Living Services, Independent Living Program, and Road to Independence Program Direct Services CHF0T, CHFSS, CHPES, CH0AT X X ETVAF, ETVPS, ETVSS, ETVAP X X SFAG0, SFPES, SFSIL, SF0SS, X SFSBR, SFSRA, SF0AT

Extended Foster Care(EFC) Admin/Direct Services and dually enrolled EFC and Road to Independence Program / Postsecondary Ed & Support Svcs KRA00 X X ETVSS, ETV0T X X KRCME, KRAI0, EFCFH, EFCGH, X EFCSL, EFCOE, EFPES, EGPES, EOPES, EPESO

Medicaid Administration Eligible X X

State Access Visitation Grant Eligible X X

Safe and Stable Families Act Eligible X X

CBC Case Management Salary IV-E Training (DCTRN) Eligible X X

CBC IV-E Training (TRC0R) Eligible X X

CBC Case Management Training Technology (TRCIT) Eligible X

Training Foster/Adoptive Parent (TRFCA) Eligible X

CBC Mentor and Volunteer Program - Children’s Network of Southwest Florida CBC only Eligible x

CBC Teen Outreach Program - Children’s Network of Southwest Florida CBC only – SFT0P Eligible x

Children’s Mental Health (SED) Services Eligible X

Version FY 15-16 July 1, 2015 58 Attachment II – Organizational Chart

(Add ORG Chart)

Attachment III – Chart of Accounts

(Add Chart of Accounts (all levels) and the Cost Pools they are associated with)

Attachment IV – (Other attachments)