April 23, 2013
Presented by:
Gail Collins
Director, Division of Program Implementation
Children’s Bureau

• Section 1130 of the Social Security Act (SSA) authorizes HHS
Secretary to approve State demonstrations involving the waiver of provisions of titles IV-E and IV-B of the SSA.
• All demonstrations must have a rigorous evaluation (process, outcome and cost) conducted by a third-party evaluator.
• All projects must be cost neutral to the Federal government, i.e., total amount of Federal funds used for demonstration must not exceed the amount of Federal funds that would have been provided under titles IV-B and IV-E in the absence of the demonstration.

• Unlike discretionary grants, waiver demonstration projects do not provide additional funding to carry out new services. Instead they allow more flexible use of Federal funds to test new approaches to service delivery.
• Projects must generate reduced title IV-E costs
(usually IV-E foster care) in order to pay for other child welfare services (e.g., prevention, in-home services, post-permanency supports, etc.)

• Section 1130 waiver authority, established in 1994 through Public Law 103–432, gave HHS Secretary authority to approve total of 10 State demonstrations.
• Adoption and Safe Families Act (ASFA) of 1997 extended and expanded HHS’s authority to use waivers for child welfare programs by allowing up to 10 new waiver
demonstrations each year.
• Authority approve new waiver demonstrations expired on March 31, 2006.
 Projects approved before that time were allowed to be complete demonstration and be amended or extended.

• Authority for new waiver demonstrations re-established through the Child and Family Services Improvement and Innovation Act (P.L.
112-34), signed into law September 30, 2011.
• Re-authorized HHS to approve up to 10 new waivers in each of
Federal Fiscal Years (FFYs) 2012 through 2014.
• Major new provisions include:
 Tribes, tribal organizations/consortia approved to directly operate title
IV-E may apply
 IV-E agencies must implement at least two child welfare Program
Improvement Policies (from a list provided in the statute)
• All waivers (both existing and new) must end by
September 30, 2019.

• Section 1130 of the SSA now requires that all new projects must address one or more of the following goals:
 Increase permanency for all infants, children, and youth by reducing the time in foster placements when possible and promoting a successful transition to adulthood for older youth.
 Increase positive outcomes for infants, children, youth, and families in their homes and communities, including tribal communities, and improve the safety and well-being of infants, children, and youth.
 Prevent child abuse and neglect and the re-entry of infants, children, and youth into foster care.

HHS Priorities under Waiver Authority
• Address trauma experienced by maltreated children through trauma-
informed programs/practices.
• Improve social, emotional, behavioral, cognitive well-being and functioning of children, with a particular emphasis on children in longterm foster care or hardest to place in permanent homes.
• Yield more than modest improvements in the lives of children and families through the implementation of evidence-based programs and practices.
• Leverage involvement of other resources and organizational partners to make concurrent improvements in child welfare and related program areas (e.g., partnerships with state Medicaid and mental
health agencies).

Status of Past and Current Waivers
• Since 1994, 23 States have implemented one or more demonstrations under the original waiver authority in multiple areas (e.g., subsidized guardianship, flex. funding, managed care, substance abuse services).
• 6 States (CA, FL, IL, IN, OH, OR) have active demonstrations that began under the original waiver authority.
• 9 States (AR, CO, IL, MA, MI, PA, UT, WA, WI) received approval in FFY 2012 to implement demonstrations under the new waiver authority. All are currently in developmental phase.
• Several proposals for new waivers for FFY 2013 are currently under review by HHS.

Child Welfare Waiver Demonstration Projects
April 2013
REGION X
REGION VIII
REGION VII
REGION I
WA
REGION V
ME
MT
OR
MN
REGION II
NH
WI
MI
CT
MA
UT
CO
IA
IL IN
OH
PA
DE
MD
CA
AZ
NM
AR
TN
REGION IX
MS
REGION VI
Completed Demonstrations
REGION IV
Continuing Demonstrations
New Demonstrations
Concurrent Continuing and New Demonstrations
* California, Illinois, Michigan, Oregon, and Wisconsin also have completed demonstrations
NC
FL
VA
REGION III

Overview of Ongoing Demonstrations
State
Demonstration
Focus
Evaluation Design
California
Florida
Flexible Funding
Flexible Funding
Illinois (AODA)
Recovery Coach Services for Parents with Substance
Use Disorders
Longitudinal/
Time Series
Longitudinal/Time
Series
Experimental
Indiana
Ohio
Oregon
Flexible Funding
Flexible Funding (Core Interventions: Family Team
Meetings and Kinship Supports)
Relationship-Based Visitation and Parent Mentoring
Longitudinal/
Time Series
Comparison
Group/Site
Experimental

State
Arkansas
Colorado
Illinois (IB3)
Massachusetts
Michigan
Pennsylvania
Utah
Washington
Wisconsin
Overview of New Demonstrations
Demonstration
Focus
Enhanced Assessment, Family Engagement, and Differential
Response
Enhanced Family Engagement, Assessment, Kinship Supports, and Trauma-Informed Services
Evaluation Design
Longitudinal/
Time Series
Matched Case and
Longitudinal/Time Series
Experimental Illinois Birth to Three: Parenting Education and Support Services for Families with Children 0-3
Enhanced Residential and Community-Based Services to Reduce
Use of Congregate Care
Intensive Early Intervention and Case Management and Services
Matched Case and
Longitudinal/
Time Series
Experimental
Enhanced Family Engagement, Assessment, and Service Array
Enhanced Assessment, Caseworker Tools and Training, and
Evidence-Based In-Home Service Array
Differential Response
Post-Reunification Case Management and Services
Longitudinal/
Time Series
Longitudinal/
Time Series
Matched Case
Matched Case

Waiver Demonstrations: Overview of Programmatic Elements
• Expanded use of clinical/functional assessments (e.g., CANS)
• Evidence-based/trauma-informed programs and practices (e.g.,
Parent-Child Interaction Therapy, Multi-Systemic Therapy, Nurturing
Parent Program)
• Parent education and mentoring programs
• Family Finding, Kinship Navigator programs
• Intensive family preservation and stabilization
• Family-centered case management models (e.g., Family Team
Meetings, Family Group Decision Making)
• Permanency Roundtables
• Enhanced/supervised visitation
• Alternative/Differential Response
• Time-limited, case-specific concrete goods and services (e.g., assistance with transportation, child care, rent or utility payments)

• For more information about waiver demonstrations, please see Children’s Bureau website: http://www.acf.hhs.gov/programs/cb/programs/childwelfare-waivers
 Information Memorandum ACYF-CB-IM-12-05
 Sample Waiver Terms and Conditions
 Summaries of Projects
 Technical Assistance Materials