The First Twelve Models That Could be Cleared for Family First Act Funding

The Family First Prevention Services Act requires the establishment of an evidence-based clearinghouse.

The Children’s Bureau released a slew of information on the Family First Prevention Services Act late last week, including the most anticipated info: A list of the first programs and models to be considered for the law’s newly established clearinghouse.

It’s sort of like the Amazon HQ shortlist for Family First nerds, although all of these might end up getting chosen.

To quickly refresh: Family First amended the Title IV-E foster care entitlement to include cost-sharing on some services to prevent the need for foster care in certain cases. There are three avenues of foster care prevention services: mental health, substance abuse and parenting.

But the law only allows cost sharing for models of service that are deemed to be evidence-based by a Family First Clearinghouse, which Abt Associates is in the process of constructing right now. There are three tiers of evidence base: Well-Supported, Supported and Promising. Half of a state’s expenditures in this area must be on stuff in the Well-Supported tier.

Following is a list of the first models and programs that the clearinghouse will assess. We include the ratings on the California Evidence-Based Clearinghouse (CEBC), which uses a similar framework as the one intended for the Family First Clearinghouse.

Mental Health

Parent-Child Interaction Therapy (PCIT)

What It Is: A model to serve families with young children who exhibit behavioral or parent relationship problems. PCIT imparts play therapy skills for parents to use.

Rating on CEBC: Well-Supported

Trauma Focused-Cognitive Behavioral Therapy (CBT)

What It Is: This version of CBT is designed to serve children with an established history of trauma who are experiencing sexual behavior problems and post-traumatic stress disorder.

Rating on CEBC: Supported

Multi-Systemic Therapy (MST)

What It Is: There are three versions of MST with ratings on the CEBC. One focuses on adolescents with substance abuse issues; one focuses on sexually abusive behavior by adolescents; and the third is for use with families that have come to the attention of the child welfare system because of maltreatment.

Rating on CEBC: The abuse and neglect model of MST is rated Supported by the CEBC. Both of the other models are rated as Well-Supported.

Note: This model is also being considered for inclusion under the Substance Abuse portfolio of the Clearinghouse.

Functional Family Therapy

What It Is: A family intervention model used with households that include an adolescent exhibiting conduct disorder, substance abuse or is acting out violently.

Rating on CEBC: Supported

Substance Abuse

Methadone Maintenance Therapy (MMT)

What It Is: This might be the most interesting name on the list, because its inclusion would represent a broader interpretation of foster care prevention services under the act. MMT is not a model used exclusively for parents with at-risk children, or even just parents at all. It is a medication-assisted treatment of addiction.

Rating on CEBC: Not rated. Click here for a rundown of findings on MMT.

Families Facing the Future

What It Is: This model is for parents with young or adolescent children, and who are receiving methadone treatment. The program includes a family retreat, and 32 parenting sessions conducted over a 16-week period (kids attend some of them, others just parents).

Rating on CEBC: Supported

Motivational Interviewing

What It Is: The goal of this model is to resolve ambivalence around trying to address substance abuse issues, and fostering the motivation to do so. The target population is parents who have come to the attention of the child welfare system.

Rating on CEBC: Well-Supported

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In-Home Parent Skill-Based

Nurse-Family Partnership (NFP)
Healthy Families America (HFA)
Parents as Teachers

What They Are: We’re grouping these together here because all of these are versions of home visiting, a strategy that involves trained professionals providing guidance and assistance to new or young mothers. This is the second big potential boost for federal investment in home visiting: the Affordable Care Act established the Maternal, Infant and Early Childhood Home Visiting (MIECHV) program, which has since been reauthorized at $400 million per year.

Rating on CEBC: NFP is ranked as well-supported in all of its forms, including a teen pregnancy model, which surely will make it a favorite in Family First spending to serve pregnant or parenting teens in foster care. Parents as Teachers is rated Promising by CEBC.

Healthy Families America has an odd mix of ratings. As a model for “child well-being,” CEBC ranks it as Well-Supported; read our recent story where New York officials credit the state’s HFA program with helping drive down the number of newborns who are taken into foster care.

But as a model for “the prevention of child abuse and neglect,” it receives the lowest rating possible: “Evidence Fails to Demonstrate Effect.”

It is worth noting that HFA has recently announced a new adaptation of its model that is designed to serve households where the child is not a newborn. Parents can be referred for this model up until the child reaches 2 years in age. This might ultimately be the model considered for Family First clearinghouse inclusion.

Kinship Navigator Programs

Children’s Home Society of New Jersey Kinship Navigator Model
Children’s Home Inc. Kinship Interdisciplinary Navigation Technologically-Advanced Model (KIN-Tech)

Kinship navigators are not part of the foster care prevention portion of the bill. But they are a critical piece of the overall puzzle.

The navigator model is meant to provide support, assistance and resources to relatives who are caring for the child of a family member. Family First envisions some of its front-end services requiring some involvement by extended family, who can take a child in for some or all of the time a parent is in a mental health or substance abuse program.

Family First offers a 50-50 federal split on the cost of kinship navigators, but only for a model that is deemed “evidence-based.” Over the summer, Children’s Bureau Associate Commissioner Jerry Milner told the House Ways and Means Committee that the administration had not yet identified an existing navigator model (there are about 70) that had been evaluated in such a way as to demonstrate evidence of impact.

Advocates for relative caregivers are likely overjoyed to see not one, but two versions up for consideration. The models are both variations used by regional members of Children’s Home Society of America (CHSA), which intends to take an active role in shaping the Family First landscape. The Wicked Problems Institute, an annual forum put on by CHSA and the University of North Carolina’s social work school, focused its program this year almost entirely on Family First.

Youth Services has heard from several folks in the kinship advocacy world this year that KIN-Tech, the model used in several Florida counties, was the most likely to be able to demonstrate an evidence base.

Join us on Thursday, December 13 for a webinar where Publisher Daniel Heimpel and Editor-in-Chief John Kelly will discuss the Family First Act. Click here to register!

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