Family First Transitional Bill Set to Move, with One Heartwarming Addition

The Family First Act was signed into law in February 2018, and mostly took effect in October of 2019

In late SeptemberYouth Services Insider reported on a draft bill floating around that would offer cash and some easing on restrictions to help states more quickly implement the Family First Prevention Services Act, a major overhaul of federal child welfare funding that passed in 2018 and mostly took effect last month.

That bill, with some added language spelling out details, now looks poised to move with major endorsers from both parties in both chambers. And it includes a provision to name one of the two major federal child welfare programs after MaryLee Allen, the longtime policy director at Children’s Defense Fund who passed away this year at age 74.

The Family First Transition Act was introduced in the Senate Finance Committee by Chairman Chuck Grassley (R-Iowa) and Ranking Member Ron Wyden (D-Ore.). In the House Ways and Means Committee, the bill was introduced by Reps. Jackie Walorski (R-Ind.) and Danny Davis (D-Ill.).

The Family First Act expands the Title IV-E entitlement – which currently only funds foster care and adoption services – to include efforts at preventing the use of foster care in some child welfare cases. This will be known as “IV-E Prevention,” and the list of fundable services is limited to substance abuse treatment, mental health interventions and in-home parenting programs.

The law also limits IV-E funds for placing foster youth in group homes and other “congregate care” settings. States will only be able to tap into IV-E for two weeks of funds for those placements, with exceptions for those that serve pregnant/parenting teens, youth older than 18, youth at risk of sex trafficking and youth with acute health needs.

You can click here to read the full transition legislation. Following is a summary of its three provisions:

Waiver State Sweetener: While IV-E is currently limited to covering foster care and adoption, many states have obtained a waiver that permits more flexibility to spend the funds on either services or kids, who wouldn’t normally be eligible.

Many of these states, fearing a drop-off in funding levels under Family First, have been fervently pushing for a two-year extension on waivers, which all expire in September. There is a bill in both chambers that would do this.

This new bill would not extend the waivers, but it offers payments to make up most of any losses that the states could demonstrate. The bill would guarantee 90 percent of waiver funds for fiscal 2020, and 75 percent of the funds for fiscal 2021.

One-time Flex Fund: A $500 million appropriation, distributed proportionately to all states to support the implementation of the act. The outline YSI saw doesn’t include any details on what is allowable for this fund, and the full bill hasn’t been introduced. We’d assume some uses states might need help with include:

  1. Updating case management and information systems to include Family First elements.
  2. Recruiting more foster parents, particularly therapeutic caregivers.
  3. Helping some group care providers establish themselves as qualified residential treatment programs (QRTP), an exception in Family First to the limits on congregate care funds.

Evidence-Based Standards: This bill will delay a rule that requires states to spend half of their Family First foster care prevention funds on programs with the highest, hardest-to-achieve rating of effectiveness.

The front end of Family First is restricted to services that are rated by a clearinghouse to have one of three tiers of evidence behind them: well-supported, supported or promising. Under the current rules of the law, 50 percent of spending under IV-E Prevention must be for things in the well-supported basket.

But the guidance on Family First has made IV-E a “payer of last resort” behind Medicaid, a much larger health care entitlement program serving low-income individuals and families. That means if Medicaid will pay for a service that’s deemed to be “well-supported,” Medicaid must pay for it.

The problem there is that the Children’s Bureau has already told one state that the only expenditures that count toward the “50 percent rule” will be IV-E expenditures. So in a state where Medicaid will pay for a lot of well-supported programs, it will be tough to demonstrate enough IV-E spending to be compliant with Family First.

The transition bill would delay the 50 percent rule until 2022. Then, for 2022 and 2023, states would have to show 50 percent of spending was on well-supported or supported programs.

In addition to those moves, the bill changes the name of the Promoting Safe and Stable Families Act to the MaryLee Allen Promoting Safe and Stable Families Act.

The program is subpart 2 of Title IV-B, the federal funding stream to support the prevention of abuse and neglect. Subpart 1 is named after Stephanie Tubbs Jones (D-Ohio), an influential member of the House Ways and Means Committee who represented the Cleveland area in Congress from 1999 until her sudden death from a brain aneurysm in 2008.

It is hard to imagine anyone being more deserving of the honor than Allen, who for decades helped build momentum for child welfare policy improvements on Capitol Hill.

“MaryLee’s views are incorporated into every piece of federal legislation over the past 30 years,” said Cassie Statuto Bevan, a fellow at the University of Pennsylvania, in an e-mail to YSI after Allen’s death this summer. She “never confused different points of view with not caring about children. That made her so effective and that makes her loss all the more devastating.”

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