	Introduction

Under Title IV-E of the Social Security Act, states, territories, and tribes are entitled to claim partial federal reimbursement for the cost of providing foster care, adoption assistance, and kinship guardianship assistance to children who meet federal eligibility criteria. The Title IV-E program, as it is commonly called, provides support for monthly payments on behalf of eligible children, as well as funds for related case management activities, training, data collection, and other costs of program administration. For FY2013, states spent $12.3 billion under the Title IV-E program and expected to receive federal reimbursement of $6.7 billion, or 54% of that spending. To be eligible to claim federal support under the Title IV-E program, a state, territory, or tribe must have a Title IV-E plan that is approved by the U.S. Department of Health and Human Services (HHS), Administration for Children and Families (ACF). Spending related to meeting these requirements is included as part of the foster care case planning and pre-placement activities; licensing, recruitment, and background check category shown in Figure 1 . Overview of Requirements Related to Children's Safety, Permanence, and Well-Being

Apart from providing assistance to eligible children, the state, territorial, or tribal agency operating a Title IV-E program must have an approved Title IV-E plan that provides for policies and procedures to accomplish the following nine purposes:
Enable children to be reunited with their families or prevent their entry to foster care (e.g., by making "reasonable efforts"—in nearly all cases—to prevent children's entry into foster care or to reunite children with their families, including by developing a plan for each child that describes services and activities necessary to permit reunification). For an overview of case review components, including case planning and permanency planning requirements, see Figure 2 at the end of this report. Further, the law changes the language of current policy to indicate these services (as well as those previously provided for in the law) are intended to ensure a youth may make a successful transition from foster care to adulthood. Children and Youth to Whom the Procedures Apply

The procedures to identify, document in agency records, and determine services for victims of, or those at risk of, sex trafficking must apply to all children in the care, placement, or supervision of the state child welfare agency, including 
c hildren who are in foster care and under age 18 (or up to any age under 21, if the state has elected to serve such older youth with Title IV-E foster care assistance); children (under age 18) who are not in foster care but for whom the agency has an open case file; youth (up to age 21, or 23 in limited circumstances) who are receiving services under the Chafee Foster Care Independence Program (CFCIP); and children who run away from foster care, provided they have not reached the age at which the state ends Title IV-E assistance (or have not been formally discharged from care). The population of children and youth who run away or are missing from care is varied.
Under Title IV-E of the Social Security Act, states, territories, and tribes are entitled to claim partial federal reimbursement for the cost of providing foster care, adoption assistance, and kinship guardianship assistance to children who meet federal eligibility criteria. The Title IV-E program, as it is commonly called, provides support for monthly payments on behalf of eligible children, as well as funds for related case management activities, training, data collection, and other costs of program administration. For FY2013, states spent $12.3 billion under the Title IV-E program (both federal and state dollars); at least 25% of this spending (some $3.1 billion) was expended for the types of "administrative" program costs described in this report, including case planning and pre-placement activities related to children in or entering foster care, as well as licensing, recruitment, and background checks and other costs related to foster care providers.
As a condition of receiving this funding, states, territories, and tribes must have a Title IV-E plan that is approved by the U.S. Department of Health and Human Services (HHS), Administration for Children and Families. That plan must ensure direct financial assistance is made available to eligible children under the Title IV-E program. Further, it must ensure that the state, territory, or tribe will adhere to federal plan requirements primarily intended to ensure children's safety, permanence, and well-being.
The focus of this report is Title IV-E plan requirements other than those related to provision of direct financial assistance to eligible children. Those requirements are intended to (1) enable children to be reunited with their families or prevent their entry to foster care; (2) promote children's placement with relatives and maintain sibling connections; (3) ensure children's living arrangements are safe and appropriate and permit "normalcy"; (4) provide for regular oversight and review of each child's status in foster care and timely development and implementation of a permanency plan; (5) ensure timely efforts to find a permanent home for children or youth who cannot be reunited with their families; (6) ensure the health care and education needs of children in foster care are addressed; (7) help youth make a successful transition from foster care to adulthood; (8) identify, document, and determine services necessary for child welfare-involved children or youth who are victims (or at risk of) of sex trafficking and locate and respond to children or youth who run away or are missing from foster care; and (9) ensure program coordination and collaboration and meet certain administrative standards.