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Title 45Subtitle BChapter XIIISubchapter GPart 1355 → Appendix


Title 45: Public Welfare
PART 1355—GENERAL


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 elementData element descriptionNumber of numeric characters
01I.ATitle IV-E agency2
02I.BReport period ending date6
03I.CLocal Agency FIPS code (county or equivalent jurisdiction) or other ACF assigned code5
04I.DRecord number12
05I.EDate of most recent periodic review8
06II.AChild's date of birth8
07II.BSex1
08II.C.1Race
08aAmerican Indian or Alaska native1
08bAsian1
08cBlack or African American1
08dNative Hawaiian or Other Pacific Islander1
08eWhite1
08fUnable to Determine1
09II.C.2Hispanic or Latino Ethnicity1
10II.DHas 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.
11II.D.1.aMental retardation1
12II.D.1.bVisually or hearing impaired1
13II.D.1.cPhysically disabled1
14II.D.1.dEmotionally disturbed (DSM III)1
15II.D.1.eOther medically diagnosed condition requiring special care1
16II.E.1Has this child ever been adopted1
17II.E.2If yes, how old was the child when the adoption was legalized?1
18III.A.1Date of first removal from home8
19III.A.2Total number of removals from home to date2
20III.A.3Date child was discharged from last foster care episode8
21III.A.4Date of latest removal from home8
22III.A.5Removal transaction date8
23III.B.1Date of placement in current foster care setting8
24III.B.2Number of previous placement settings during this removal episode2
25IV.AManner of removal from home for current placement episode1
   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.
26IV.B.1Physical abuse (alleged/reported)1
27IV.B.2Sexual abuse (alleged/reported)1
28IV.B.3Neglect (alleged/reported)1
29IV.B.4Alcohol abuse (parent)1
30IV.B.5Drug abuse (parent)1
31IV.B.6Alcohol abuse (child)1
32IV.B.7Drug abuse (child)1
33IV.B.8Child's disability1
34IV.B.9Child's behavior problem1
35IV.B.10Death of parent(s)1
36IV.B.11Incarceration of parent(s)1
37IV.B.12Caretaker's inability to cope due to illness or other reasons1
38IV.B.13Abandonment1
39IV.B.14Relinquishment1
40IV.B.15Inadequate housing1
41V.ACurrent placement setting1
42V.BOut of State/Tribal service area placement1
43VIMost recent case plan goal1
44VII.ACaretaker family structure1
45VII.B.1Year of birth (1st principal caretaker)4
46VII.B.2Year of birth (2nd principal caretaker)4
47VIII.ADate of mother's parental rights termination8
48VIII.BDate of legal or putative father's parental rights8
49IX.AFoster family structure1
50IX.B.1Year of birth (1st foster caretaker)4
51IX.B.2Year of birth (2nd foster caretaker)4
52IX.C.1Race of 1st foster caretaker
52aAmerican Indian or Alaska Native1
52bAsian1
52cBlack or Asian American1
52dNative Hawaiian or Other Pacific Islander1
52eWhite1
52fUnable to Determine1
53IX.C.2Hispanic or Latino ethnicity of 1st foster caretaker1
54IX.C.3Race of 2nd foster caretaker
54aAmerican Indian or Alaska Native1
54bAsian1
54cBlack or African American1
54dNative Hawaiian or Other Pacific Islander1
54eWhite1
54fUnable to Determine1
55IX.C.4Hispanic or Latino ethnicity of 2nd foster caretaker1
56X.A.1Date of discharge from foster care8
57X.A.2Foster care discharge transaction date8
58X.BReason for discharge1
   Sources of Federal support/assistance for child; indicate with a “1” for elements 58-64 and a zero for sources that do not apply.
59XI.ATitle IV-E (Foster Care)1
60XI.BTitle IV-E (Adoption Assistance)1
61XI.CTitle IV-A (Aid to Families With Dependent Children)1
62XI.DTitle IV-D (Child Support)1
63XI.ETitle XIX (Medicaid)1
64XI.FSSI or other Social Security Act benefits1
65XI.GNone of the above1
66XIIAmount of monthly foster care payment (regardless of source)5
   Total characters197

2. Foster Care Semi-Annual Summary Data Elements Record

a. The record will consist of 22 data elements.

The values for these data elements are generated by processing all records in the semi-annual detailed data transmission and computing the summary values for Elements 1 and 3-22. Element 2 is the semi-annual report period ending date. In calculating the age range for the child, the last day of the reporting period is to be used.

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

(1) Enter the appropriate value for each element.

(2) For all elements where the total is zero, enter a numeric zero.

(3) Enter date values in year, month order (YYYYMM), e.g.,199912 for December 1999.

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

Element No.Summary data fileNumber of
characters
01Number of records8
02Report period ending date (YYYYMM)6
03Children in care under 1 year8
04Children in care 1 year old8
05Children in care 2 years old8
06Children in care 3 years old8
07Children in care 4 years old8
08Children in care 5 years old8
09Children in care 6 years old8
10Children in care 7 years old8
11Children in care 8 years old8
12Children in care 9 years old8
13Children in care 10 years old8
14Children in care 11 years old8
15Children in care 12 years old8
16Children in care 13 years old8
17Children in care 14 years old8
18Children in care 15 years old8
19Children in care 16 years old8
20Children in care 17 years old8
21Children in care 18 years old8
22Children in care over 18 years old8
   Record Length174

B. Adoption

1. Adoption Semi-Annual Detailed Data Elements Record

a. The record will consist of 37 data elements.

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

(1) 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 (YYYYMM), e.g., 199910 for October 1999. Leave the element value blank if dates are not applicable.

(3) For elements 7, 11-15, 25, 27 and 29-32 which are “select all that apply” elements, enter a “1” for each element that applies; enter a zero for non-applicable elements.

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

Element No.Appendix B data elementData element descriptionNumber of numeric characters
01I.ATitle IV-E agency2
02I.BReport period ending date6
03I.CRecord number6
04I.DTitle IV-E agency involvement1
05II.ADate of birth6
06II.BSex1
07II.C.1Race
07aAmerican Indian or Alaska Native1
07bAsian1
07cBlack or African American1
07dNative Hawaiian or Other Pacific Islander1
07eWhite1
07fUnable to Determine1
08II.C.2Hispanic or Latino ethnicity1
09III.AHas the title IV-E agency determined that this child has special needs1
10III.BPrimary basis for special needs1
   Indicate a primary basis of special needs with a “1” for elements 11-15. Enter a zero for special needs that do not apply.
11III.B.1.aMental retardation1
12III.B.1.bVisually or hearing impaired1
13III.B.1.cPhysically disabled1
14III.B.1.dEmotionally disturbed (DSM III)1
15III.B.1.eOther medically diagnosed condition requiring special care1
16IV.A.1Mother's year of birth4
17IV.A.2Father's (Putative or legal) year of birth4
18IV.BWas the mother married at time of child's birth1
19V.A.1Date of mother's termination of parental rights8
20V.A.2Date of father's termination of parental rights8
21V.BDate adoption legalized8
22VI.AAdoptive parents family structure1
23VI.B.1Mother's year of birth (if applicable)4
24VI.B.2Father's year of birth (if applicable)4
25VI.C.1Adoptive mother's race
25aAmerican Indian or Alaska Native1
25bAsian1
25cBlack or African American1
25dNative Hawaiian or Other Pacific Islander1
25eWhite1
25fUnable to Determine1
26VI.C.2Hispanic or Latino Ethnicity1
27VI.C.3Adoptive father's race
27aAmerican Indian or Alaska Native1
27bAsian1
27cBlack or African American1
27dNative Hawaiian or Other Pacific Islander1
27eWhite1
27fUnable to Determine1
28VI.C.4Hispanic or Latino Ethnicity1
   Indicate each type of relationship of adoptive parent(s) to the child with a “1” for elements 29-32. Enter a zero for relationships that do not apply below.
29VI.D.1Stepparent1
30VI.D.2Other relative of child by birth or marriage1
31VI.D.3Foster parent of child1
32VI.D.4Other non-relative1
33VII.AChild was placed from1
34VII.BChild was placed by1
35VIII.AIs this child receiving a monthly subsidy1
36VIII.BIf VIII.B is “yes.” What is the monthly amount5
37VIII.CIf VII.B is “yes.” Is the child receiving title IV-E adoption assistance?1
   Total Characters

2. Adoption Semi-Annual Summary Data Elements Record

a. The record will consist of 22 data elements.

The values for these data elements are generated by processing all records in the semi-annual detailed data transmission and computing the summary values for Elements 1 and 3-22. Element 2 is the semi-annual report period ending date. In calculating the age range for the child, the last day of the reporting period is to be used.

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

(1) Enter the appropriate value for each element.

(2) For all elements where the total is zero, enter a numeric zero.

(3) Enter data values in year, month order (YYYYMM), e.g., 199912 for December 1999.

c. Adoption Semi-Annual Summary Data Element Record Layout follows:

Element No.Summary data file Number of
characters
01Number of records8
02Report period ending date (YYYYMM)6
03Children adopted Under 1 year old8
04Children adopted 1 year old8
05Children adopted 2 years old8
06Children adopted 3 years old8
07Children adopted 4 years old8
08Children adopted 5 years old8
09Children adopted 6 years old8
10Children adopted 7 years old8
11Children adopted 8 years old8
12Children adopted 9 years old8
13Children adopted 10 years old8
14Children adopted 11 years old8
15Children adopted 12 years old8
16Children adopted 13 years old8
17Children adopted 14 years old8
18Children adopted 15 years old8
19Children adopted 16 years old8
20Children adopted 17 years old8
21Children adopted 18 years old8
22Children adopted over 18 years old8
   Record Length174

[77 FR 934, Jan. 6, 2012]

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