Title 45

PART 1355 APPENDIX D


Appendix D to Part 1355 - Foster Care and Adoption Record Layouts

45:5.1.2.7.20.0.8.33.8 : Appendix D

Appendix D to Part 1355 - Foster Care and Adoption Record Layouts Link to an amendment published at 81 FR 90584, Dec. 14, 2016. This amendment was delayed until Oct. 1, 2020, at 83 FR 42225, Aug. 21, 2018. This amendment was further delayed until Oct. 1, 2022, at 85 FR 28410, May 12, 2020. A. Foster Care 1. Foster Care Semi-Annual Detailed Data Elements Record

a. The record will consist of 66 data elements.

b. Data must be supplied for each of the elements in accordance with these instructions:

(1) All data must be numeric. Enter the appropriate value for each element.

(2) Enter date values in year, month and day order (YYYYMMDD), e.g., 19991030 for October 30, 1999, or year and month order (YYYYMM), e.g., 199910 for October 1999. Leave the element value blank if dates are not applicable.

(3) For elements 8, 11-15, 26-40, 52, 54 and 59-65, which are “select all that apply” elements, enter a “1” for each element that applies, enter a zero for non-applicable elements.

(4) Transaction Date - is a computer generated date indicating when the datum (Elements 21 or 55) is entered into the title IV-E agency's automated information system.

(5) Report the status of all children in foster care as of the last day of the reporting period. Also, provide data for all children who were discharged from foster care at any time during the reporting period, or in the previous reporting period, if not previously reported.

c. Foster Care Semi-Annual Detailed Data Elements Record Layout follows:

Element No. Appendix A data element Data element description Number of numeric characters
01 I.A Title IV-E agency 2
02 I.B Report period ending date 6
03 I.C Local Agency FIPS code (county or equivalent jurisdiction) or other ACF assigned code 5
04 I.D Record number 12
05 I.E Date of most recent periodic review 8
06 II.A Child's date of birth 8
07 II.B Sex 1
08 II.C.1 Race
08a American Indian or Alaska native 1
08b Asian 1
08c Black or African American 1
08d Native Hawaiian or Other Pacific Islander 1
08e White 1
08f Unable to Determine 1
09 II.C.2 Hispanic or Latino Ethnicity 1
10 II.D Has this child been clinically diagnosed as having a disability(ies) 1
Indicate each type of disability of the child with a “1” for elements 11-15 and a zero for disabilities that do not apply.
11 II.D.1.a Mental retardation 1
12 II.D.1.b Visually or hearing impaired 1
13 II.D.1.c Physically disabled 1
14 II.D.1.d Emotionally disturbed (DSM III) 1
15 II.D.1.e Other medically diagnosed condition requiring special care 1
16 II.E.1 Has this child ever been adopted 1
17 II.E.2 If yes, how old was the child when the adoption was legalized? 1
18 III.A.1 Date of first removal from home 8
19 III.A.2 Total number of removals from home to date 2
20 III.A.3 Date child was discharged from last foster care episode 8
21 III.A.4 Date of latest removal from home 8
22 III.A.5 Removal transaction date 8
23 III.B.1 Date of placement in current foster care setting 8
24 III.B.2 Number of previous placement settings during this removal episode 2
25 IV.A Manner of removal from home for current placement episode 1
Actions or conditions associated with child's removal: Indicate with a “1” for elements 26-40 and a zero for conditions that do not apply.
26 IV.B.1 Physical abuse (alleged/reported) 1
27 IV.B.2 Sexual abuse (alleged/reported) 1
28 IV.B.3 Neglect (alleged/reported) 1
29 IV.B.4 Alcohol abuse (parent) 1
30 IV.B.5 Drug abuse (parent) 1
31 IV.B.6 Alcohol abuse (child) 1
32 IV.B.7 Drug abuse (child) 1
33 IV.B.8 Child's disability 1
34 IV.B.9 Child's behavior problem 1
35 IV.B.10 Death of parent(s) 1
36 IV.B.11 Incarceration of parent(s) 1
37 IV.B.12 Caretaker's inability to cope due to illness or other reasons 1
38 IV.B.13 Abandonment 1
39 IV.B.14 Relinquishment 1
40 IV.B.15 Inadequate housing 1
41 V.A Current placement setting 1
42 V.B Out of State/Tribal service area placement 1
43 VI Most recent case plan goal 1
44 VII.A Caretaker family structure 1
45 VII.B.1 Year of birth (1st principal caretaker) 4
46 VII.B.2 Year of birth (2nd principal caretaker) 4
47 VIII.A Date of mother's parental rights termination 8
48 VIII.B Date of legal or putative father's parental rights 8
49 IX.A Foster family structure 1
50 IX.B.1 Year of birth (1st foster caretaker) 4
51 IX.B.2 Year of birth (2nd foster caretaker) 4
52 IX.C.1 Race of 1st foster caretaker
52a American Indian or Alaska Native 1
52b Asian 1
52c Black or Asian American 1
52d Native Hawaiian or Other Pacific Islander 1
52e White 1
52f Unable to Determine 1
53 IX.C.2 Hispanic or Latino ethnicity of 1st foster caretaker 1
54 IX.C.3 Race of 2nd foster caretaker
54a American Indian or Alaska Native 1
54b Asian 1
54c Black or African American 1
54d Native Hawaiian or Other Pacific Islander 1
54e White 1
54f Unable to Determine 1
55 IX.C.4 Hispanic or Latino ethnicity of 2nd foster caretaker 1
56 X.A.1 Date of discharge from foster care 8
57 X.A.2 Foster care discharge transaction date 8
58 X.B Reason for discharge 1
Sources of Federal support/assistance for child; indicate with a “1” for elements 58-64 and a zero for sources that do not apply.
59 XI.A Title IV-E (Foster Care) 1
60 XI.B Title IV-E (Adoption Assistance) 1
61 XI.C Title IV-A (Aid to Families With Dependent Children) 1
62 XI.D Title IV-D (Child Support) 1
63 XI.E Title XIX (Medicaid) 1
64 XI.F SSI or other Social Security Act benefits 1
65 XI.G None of the above 1
66 XII Amount of monthly foster care payment (regardless of source) 5
Total characters 197