Proposal Form

University Name:

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Academic Year:

Prepared by:

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Part 1

School Information

Part 2

General Description

Part 3

Proposal Narrative

Part 4

Recruitment & Retention

Part 5

Budget

Part 7

Supporting Documents
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School Information













Title IV-E Program General Description


Please check all boxes for which IV-E Program will be active
Full Time Part Time DFCS Seed Students
# of BSW
# Of MSW

A stipulation for participation in the Title IV-E program requires each school to have a minimum of two child welfares courses in their curriculum. The courses must include information that aligns with the current DFCS New Case Manager Training. The case manager training is a series of learning modules that support new workers in the field of child welfare. Specific topics include an introduction to child welfare services, family assessment, child maltreatment, effect of trauma on child development, child placement and the legal system, process for child welfare reviews and performance improvement plans.
Course Number List the two child welfare course titles that satisfy the above description
1
2

School Proposal Narrative


Describe the emphasis of the Title IV-E program at your institution (generalist, clinical, administrative; undergraduate, graduate, both, etc.). Include in your program description how the Title IV-E will meet DFCS regional hiring needs in your locality.
Name Of Course Competency Description Provide Course Title and Numbers, and/ or Brief program Activity Description Action
Complex Cognitive Skills Course/program activities that promote reflective thought, critical thinking, cultural competency, quantitative reasoning and intellectual flexibility.
Ethical Practice in Child Walfare Course/program activities that promote ethical standards and values for public child welfare practice.
Knowledge Acquisition Course/program activities that promote student mastery of child welfare knowledge on principles, policies, practice and procedures as taught in the classroom setting.
Practical Competence in Public Child Welfare institutions Program activities that promote selfawareness, Self-reflection, and understanding of institutional power and authority
Academic Achievement Program activities that assist students'to maintain required minimum grades for each course in the curriculum.
Persistence/ Retention Program activities that support and guidance to students from enrollment to successful graduation.
Incorporation of DFCS New Worker Training Materials Describe how the new worker training matetials will be used to provide enhanced learning for Title IV-E Students.
Competency Description Provide Course Title and Numbers, and/ or Brief Program Activity Description Action
Knowledge Acquisition Course/Program activities that promote student mastery of child welfare knowledge on principles, policies, policies, practice and procedures as taught in the field setting.
Field Practice Competence Courses/activities that integrate curriculum knowledge with practice application.
Additional Experiences Describe other unique experiences, outside of the classroom, that will be offered to Title IV-E students (e.g, individual/group coaching, mentoring, tutoring, field student chat rooms, etc.)

Recruitment & Retention Plan

Budget

1. Administrative Staff Costs
Administrative Staff Name Base
Salary		 % of Time Dedicated Annual Budget to IV-E Program %Title IV-E Material
curriculum statistic		 Eligibility
Rate		 Reportable Costs Federal
Share		 Federal Reimbursement University Reimbursement Required? Action
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50%
1
n/a
  
Administrative Faculty Costs Subtotals
 
 
Budget Justifications Please include job title/function (e.g.: P.I., program director, administrative coordinator, GRAs) for all personnel listed in this section.
Provide detail justification for administrative personnel with an indication of "university reimbursement required" must include detail justification of support to delivery of Title IV-E program.
2. Faculty & Teaching Costs
Faculty & Teaching Costs Base
Salary		 % ofTime Dedicated Annual Budget to IV-E Program %Title IV-E Material
curriculum statistic		 Eligibility Rate Reportable Costs Federal Share Federal Reimbursement University Reimbursement Required? Action
70%
47%
75%
1
  
Faculty & Teaching Costs Subtotals:
 
Budget Justifications Percentages for personnel listed in the following sections should be based on 12.5% per class taught.
Personnel with an indication of "university reimbursement required" must include detail justification in support of exclusive Title IV-E services to students.
IV-E Teaching Staff Costs
IV-E Teaching Staff Costs Base Salary % of Time Dedicated Annual Budget to IV-E Program % Title IV-E Material
curriculum statistic		 Eligibility Rate Reportable Costs Federal Share Federal Reimbursement University Reimbursement Required? Action
70%
47%
75%
  
IV-E Teaching Staff Costs Subtotals:
 
Budget Justifications Percentages for personnel listed in the following sections should be based on 12.5% per class taught.
Personnel with an indication of "university reimbursement required" must include detail justification in support of exclusive Title IV-E services to students.
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3. Fringe Benefits for Administrative Staff Costs
Fringe Benefits for Administrative Staff Costs Fringe Benefit Rates Fringe Cost % of Time Dedicated Annual Budget to IV-E Program % Title IV-E Material
curriculum statistic		 Eligibility Rate Reportable Costs Federal Share Federal Reimbursement University Reimbursement Required?
70%
47%
50%
1
n/a
Fringe Benefits Administrative Staff Costs Subtotals:
 
Budget Justifications Please provide detail on rate variances.
Example:
Full-time faculty & staff fringe rate
Part-time staff and/or adjunct fringe rate
GRA fringe rate
Student assistant fringe rate
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4. Fringe Benefits for Faculty and Teaching Costs
Fringe Benefits for Faculty and Teaching Costs Fringe Benefit Rates Fringe Cost % of Time Dedicated Annual Budget to IV-E Program %Title IV-E Material
curriculum statistic		 Eligibility Rate Reportable Costs Federal Share Federal Reimbursement University Reimbursement Required?
70%
47%
75%
1
Fringe Benefits for Faculty and Teaching Costs Subtotals:
Budget Justifications Please provide detail on rate variances.
Example:
Full-time faculty & staff fringe rate
Part-time staff and/or adjunct fringe rate
GRA fringe rate
Student assistant fringe rate
Fringe Cost Dedicated Annual Budget to IV-E Program % Title IV-E Material
curriculum statistic		 Eligibility Rate Reportable Costs Federal Share University Required Reimbursement
Personnel Cost Totals
Direct Personnel Costs Requested
5. Training Operating Costs
Training Operating Costs Budget % of Time Dedicated Annual Budget to IV-E Program %Title IV-E Material
curriculum statistic		 Eligibility Rate Reportable Costs Federal Share Federal Reimbursement Action
70%
47%
75%
1
n/a
  
Budget Justifications Equipment/Supplies that support the delivery of Title IV-E services to students will be considered.
Note: Pre-approval may be required by DFCS may be required prior to purchases.
Training Operating Costs Subtotals:
 
 
6. Training Travel Costs
Training Travel Costs Budget % of Time Dedicated Annual Budget to IV-E Program %Title IV-E Material
curriculum statistic		 Eligibility Rate Reportable Costs Federal Share Federal Reimbursement Action
70%
47%
75%
1
n/a
  
Budget Justifications Provide a description of planned travel for faculty, staff and students.
Note: Any planned travel must be related to child welfare.
Please provide detail on exact conferences - number of students/faculty/staff attending; estimated conference registration costs and other associated cost per trip e.g. Hotel/per diem.Also include details on estimated costs associated with field placement site visits.
Training Travel Costs Subtotals:
 
 
7. Student Stipend Costs
Student StipendCosts Budget % of Time Dedicated Annual Budget to IV-E Program %Title IV-E Material
curriculum statistic		 Eligibility Rate Reportable Costs Federal Share Federal Reimbursement Action
70%
47%
75%
1
n/a
  
Student Stipend Costs Subtotals:
 
 
Budget Justifications Note: The maximum number of students per school is 20 students for the academic year.
Please be sure to list the number of students by semester for each variance degree.
Example:
# students x full-time tuition cost at the BSW/MSW level.
# students x part time tuition costs at the BSW/MSW level.
Also provide details on any variance in rate for stipend by semester or degree level.
8. Administrative Operating Costs
Administrative Operating Costs Budget % of Time Dedicated Annual Budget to IV-E Program % Title IV-E Material
curriculum statistic		 Eligibility Rate Reportable Costs Federal Share Federal Reimbursement Action
70%
47%
50%
1
n/a
  
Administrative Operating Costs Subtotals:
 
 
Budget Justifications Equipment/Supplies that support the delivery of Title IV-E program.
9. Administrative Travel Costs
Administrative Travel Costs Budget % of Time Dedicated Annual Budget to IV-E Program Curriculum Statistics Eligibility Rate Reportable Costs Federal Share Federal Reimbursement Action
70%
47%
50%
1
n/a
  
Administrative Travel Costs Subtotals:
 
 
Budget Justifications Provide detail estimated costs associated with consortium meetings.
Budget Dedicated Annual Budget to IV-E Program % Title IV-E Material
curriculum statistic		 Eligibility Rate Reportable Costs Federal Share University Required Reimbursement
Total Direct Costs:
Modified Direct Costs:
Indirect Rate:
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Indirect Cost Reimbursement to University:
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10. Total Title IV-E Budget
FEDERAL DOLLARS REQUIRED
Total Federal Reimbursement
Stipend Support:
Travel:
Reimbursment Requested
Operating expense:
Direct personnel cost:
Indirect Cost Reimbursement to University:
Difference for Admin
Total

Summer Budget

1. Administrative Staff Costs
Administrative Staff Name Base Salary % of Time Dedicated Annual Budget to IV-E Program %Title IV-E Material
curriculum statistic		 Eligibility Rate Reportable Costs Federal Share Federal Reimbursement University Reimbursement Required? Action
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50%
1
n/a
  
Administrative Faculty Costs Subtotals
 
 
Budget Justifications Please include job title/function (e.g.: P.I., program director, administrative coordinator, GRAs) for all personnel listed in this section.
Provide detail justification for administrative personnel with an indication of "university reimbursement required" must include detail justification of support to delivery of Title IV-E program.
2. Faculty & Teaching Costs
Faculty & Teaching Costs BaseSalary % ofTime Dedicated Annual Budget to IV-E Program %Title IV-E Material
curriculum statistic		 Eligibility Rate Reportable Costs Federal Share Federal Reimbursement University Reimbursement Required? Action
70%
47%
75%
1
  
Faculty & Teaching Costs Subtotals:
 
Budget Justifications Percentages for personnel listed in the following sections should be based on 12.5% per class taught.
Personnel with an indication of "university reimbursement required" must include detail justification in support of exclusive Title IV-E services to students.
IV-E Teaching Staff Costs
IV-E Teaching Staff Costs Base Salary % of Time Dedicated Annual Budget to IV-E Program % Title IV-E Material
curriculum statistic		 Eligibility Rate Reportable Costs Federal Share Federal Reimbursement University Reimbursement Required? Action
70%
47%
75%
  
IV-E Teaching Staff Costs Subtotals:
 
Budget Justifications Percentages for personnel listed in the following sections should be based on 12.5% per class taught.
Personnel with an indication of "university reimbursement required" must include detail justification in support of exclusive Title IV-E services to students.
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3. Fringe Benefits for Administrative Staff Costs
Fringe Benefits for Administrative Staff Costs Fringe Benefit Rates Fringe Cost % of Time Dedicated Annual Budget to IV-E Program % Title IV-E Material
curriculum statistic		 Eligibility Rate Reportable Costs Federal Share Federal Reimbursement University Reimbursement Required?
70%
47%
50%
1
n/a
Fringe Benefits Administrative Staff Costs Subtotals:
 
Budget Justifications Please provide detail on rate variances.
Example:
Full-time faculty & staff fringe rate
Part-time staff and/or adjunct fringe rate
GRA fringe rate
Student assistant fringe rate
*/ ?> */ ?>
4. Fringe Benefits for Faculty and Teaching Costs
Fringe Benefits for Faculty and Teaching Costs Fringe Benefit Rates Fringe Cost % of Time Dedicated Annual Budget to IV-E Program %Title IV-E Material
curriculum statistic		 Eligibility Rate Reportable Costs Federal Share Federal Reimbursement University Reimbursement Required?
70%
47%
75%
1
Fringe Benefits for Faculty and Teaching CostsSubtotals:
Budget Justifications Please provide detail on rate variances.
Example:
Full-time faculty & staff fringe rate
Part-time staff and/or adjunct fringe rate
GRA fringe rate
Student assistant fringe rate
Fringe Cost Dedicated Annual Budget to IV-E Program % Title IV-E Material
curriculum statistic		 Eligibility Rate Reportable Costs Federal Share University Required Reimbursement
Personnel Cost Totals
Direct Personnel Costs Requested
5. Training Operating Costs
Training Operating Costs Budget % of Time Dedicated Annual Budget to IV-E Program %Title IV-E Material
curriculum statistic		 Eligibility Rate Reportable Costs Federal Share Federal Reimbursement Action
70%
47%
75%
1
n/a
  
Budget Justifications Equipment/Supplies that support the delivery of Title IV-E services to students will be considered.
Note: Pre-approval may be required by DFCS may be required prior to purchases.
Training Operating Costs Subtotals:
 
 
6. Training Travel Costs
Training Travel Costs Budget % of Time Dedicated Annual Budget to IV-E Program %Title IV-E Material
curriculum statistic		 Eligibility Rate Reportable Costs Federal Share Federal Reimbursement Action
70%
47%
75%
1
n/a
  
Budget Justifications Provide a description of planned travel for faculty, staff and students.
Note: Any planned travel must be related to child welfare.
Please provide detail on exact conferences - number of students/faculty/staff attending; estimated conference registration costs and other associated cost per trip e.g. Hotel/per diem.Also include details on estimated costs associated with field placement site visits.
Training Travel Costs Subtotals:
 
 
7. Student Stipend Costs
Student StipendCosts Budget % of Time Dedicated Annual Budget to IV-E Program %Title IV-E Material
curriculum statistic		 Eligibility Rate Reportable Costs Federal Share Federal Reimbursement Action
70%
47%
75%
1
n/a
  
Student Stipend Costs Subtotals:
 
 
Budget Justifications Note: The maximum number of students per school is 20 students for the academic year.
Please be sure to list the number of students by semester for each variance degree.
Example:
# students x full-time tuition cost at the BSW/MSW level.
# students x part time tuition costs at the BSW/MSW level.
Also provide details on any variance in rate for stipend by semester or degree level.
8. Administrative Operating Costs
Administrative Operating Costs Budget % of Time Dedicated Annual Budget to IV-E Program % Title IV-E Material
curriculum statistic		 Eligibility Rate Reportable Costs Federal Share Federal Reimbursement Action
70%
47%
50%
1
n/a
  
Administrative Operating Costs Subtotals:
 
 
Budget Justifications Equipment/Supplies that support the delivery of Title IV-E program.
9. Administrative Travel Costs
Administrative Travel Costs Budget % of Time Dedicated Annual Budget to IV-E Program Curriculum Statistics Eligibility Rate Reportable Costs Federal Share Federal Reimbursement Action
70%
47%
50%
1
n/a
  
Administrative Travel Costs Subtotals:
 
 
Budget Justifications Provide detail estimated costs associated with consortium meetings.
Budget Dedicated Annual Budget to IV-E Program % Title IV-E Material
curriculum statistic		 Eligibility Rate Reportable Costs Federal Share University Required Reimbursement
Total Direct Costs:
Modified Direct Costs:
Indirect Rate:
user_level!='1') echo 'readonly="" style="background: #f7f7f7"';?>>
Indirect Cost Reimbursement to University:
user_level!='1') echo 'readonly="" style="background: #f7f7f7"';?>>
10. Total Title IV-E Budget
FEDERAL DOLLARS REQUIRED
Total Federal Reimbursement
Stipend Support:
Travel:
Reimbursment Requested
Operating expense:
Direct personnel cost:
Indirect Cost Reimbursement to University:
Difference for Admin
Total

Supporting Documents