Department of Health and Family Services
Division of Children and Family Services

                Memo Series 2001-14
                October 29, 2001

           Re:  IV-E ELIGIBILITY AND
                  POLICY MANUAL



Area Administrators/Assistant Area Administrators
Bureau Directors
County Departments of Community Programs Directors
County Departments of Developmental Disabilities Services Directors
County Departments of Human Services Directors
County Departments of Social Services Directors
Licensing Chiefs/Section Chiefs
Tribal Chairpersons/Human Services Facilitators


Susan N. Dreyfus

Document Summary

This memo transmits updated materials to use in the determination of eligibility for federal Title IV-E reimbursement of children placed in out-of-home care.

The Division has updated the Title IV-E Eligibility and Reimbursability Policy Manual and the forms used in the determination of IV-E eligibility and reimbursability of children placed in out-of-home care. The changes addressed in the new IV-E policy manual and forms supercede the previously issued policy manual dated February 1999 and forms dated May 1999. These updated materials are to be used effective immediately and earlier versions of the policy manual and forms should be discarded.

IV-E Policy Manual

The IV-E Eligibility and Reimbursability Policy Manual has been updated to address recent changes in federal Title IV-E eligibility and reimbursability policy. The policy and procedures stated in the new policy manual are consistent with the Adoption and Safe Families Act of 1997 and incorporate new Title IV-E regulations under 45 CFR Parts 1355, 1356 and 1357 that were effective March 27, 2000. The policy manual applies to all children and juveniles in out-of-home care.

There are two major concepts within the IV-E program which determine whether federal reimbursement can be claimed for a child - eligibility and reimbursability. The child must be determined IV-E eligible based on income and deprivation criteria applied to the parent(s) or relative(s) from whom the child was removed and procedural requirement must be met for the child. Once determined initially eligible, IV-E eligibility must be annually redetermined for the child over the duration of the out-of-home care episode. The child must also be determined IV-E reimbursable to claim federal reimbursement for the maintenance costs of the child. The reimbursability of the child is contingent on meeting procedural requirements and the child being placed with a reimbursable provider.

The new policy manual addresses the following major changes in eligibility and reimbursability:

Contrary to the welfare: A judicial finding that remaining in the home was contrary to the welfare of the child must be provided in the initial court order authorizing removal of the child from the home, even temporarily, for the child to be IV-E eligible. If the contrary to the welfare language is not provided in the first court order, the child is not eligible for the entire out-of-home care episode.

  • Reasonable efforts to prevent removal: Within 60 days after the child’s removal date, there must be a judicial finding of one of the following for the child to be IV-E reimbursable: a) reasonable efforts were made to prevent removal of the child, b) the situation precluded reasonable efforts, or c) reasonable efforts were not required. If the reasonable efforts language is not obtained with 60 days of the child’s removal date, the child is not reimbursable for the entire out-of-home care episode.

  • Reasonable efforts to finalize permanency plan: A judicial finding must be made every 12 months from the date of removal stating reasonable efforts were made to finalize the permanency plan. If the reasonable efforts to finalize the permanency plan finding is not made every 12 months, the child loses reimbursability until the finding is obtained.

  • Licensing issuance: IV-E reimbursement for placement costs can not be claimed until the prospective foster home satisfies all the requirements for licensure or approval. If the foster home satisfies all licensing requirements, IV-E reimbursement can be claimed for the placement costs before the actual license or approval issuance, but the time period until the actual license is issued may not exceed 60 days.

IV-E Eligibility Forms

Revisions have been made to the CFS-201, CFS-201A, and CFS-205 forms used to determine children eligible and reimbursable for IV-E funding. These revisions accommodate these policy changes as well as make the initial determination, redetermination, and AFDC relatedness forms flow more smoothly. The revised forms allow the eligibility specialist to move quickly through the determination process, answering only the questions relevant to the particular child for whom they are making an eligibility determination. The revised CFS-205 form consolidates the former CFS-205A form worksheet for deemed stepparent income.

The revised IV-E eligibility forms should be used beginning immediately and please discard all earlier versions of the IV-E eligibility forms. The new forms will be used by MAXIMUS, Inc. for those counties participating in the centralized IV-E eligibility unit. Templates related to IV-E eligibility in the WiSACWIS child welfare data system will be updated to be consistent with the revised IV-E eligibility forms.

The new forms can be downloaded from the DHFS web site and agencies can make copies of the forms attached to this memo. Agencies wishing to order copies of the forms may do so from the Forms Center in Madison. Forms will be available starting November 15, 2001. A Forms/Publications Requisition, DMT-25, must be filled out to order forms from the Division of Children and Family Services. To avoid problems with filling the request, be sure to indicate the quantity desired, the form number and the form title. Fill in your name and street address in the "ship to" area of the requisition, which will become your shipping label. Send your completed requisition to:

Department of Health & Family Services
Division of Children & Family Services
Forms Manager
PO Box 8916
Madison, WI 53708-8916

Training and Questions

Training for local agency staff on the new policy manual and forms is currently being provided at several locations around the state. The dates and registration procedure is described in DCFS Info memo 2001-15, dated October 16, 2001. Local agency staff can attend any of the training sessions.

If there are any questions concerning the updated IV-E policy manual and eligibility forms, please call the Title IV-E Hot Line at (608) 267-9647.

Thank you very much for your assistance in this important effort.



Area Administrator


Mark Mitchell
Child Welfare Services Manager
P.O. Box 8916
Madison, WI 53708-8916
Phone: (608) 266-2860
FAX: 608-264-6750


Title IV-E Eligibility and Reimbursability Manual
Form CFS-201 Title IV-E Out-of-Home Care Determination
Form CFS-201A Title IV-E Out-of-Home Care Redetermination
Form CFS-205 Out-of-Home Care Income and Resource Determination


Pamela Eitland, Division of Juvenile Corrections, DOC
Cheryl Calder, Director of State Courts Office
Kitty Kocol, Office of Crime Victim Services, DOJ

The Department of Children and Families, protecting children, strengthening families, building communities.