To request a waiver, a grantee must submit to the Department a waiver plan that:

1. (a) Describes the goals of the waiver, the expected programmatic outcomes, and how the waiver will improve the provision of program activities;
2. (b) Is consistent with any guidelines the Department establishes;
3. (c) Describes the data that will be collected to track the impact of the waiver; and
4. (d) Includes a modified program plan reflecting the effect of the requested waiver.