Group Hopes to Replicate First Regional Convening on Family First Act

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

The federal Administration for Children and Families (ACF) has already begun to set up the guidelines and rules that will govern state implementation of the Family First Prevention Services Act, a law passed in February of 2018 that aims to prevent the use of foster care more often and reduce the use of group homes and other congregate care settings.

Thus far, ACF has made two things clear through memoranda and public briefings: It will allow states to make their own interpretation, and when they have questions or seek clarifications, those should be routed through the 10 ACF regional offices. Certainly, this creates the risk of different messages coming from different offices, but it also offers a greater expectation of responsiveness when states have pressing questions.

Last month, ACF Region Seven partnered with national nonprofit St. Francis Ministries to conduct a first-ever Family First Act “implementation convening” for key stakeholders from the region’s four states: Iowa, Kansas, Missouri and Nebraska.

“There were a lot of questions and really good discussions,” said St. Francis Chief Public Policy Officer Page Walley, a former Tennessee legislator who also once ran Tennessee and Alabama child welfare agencies. “From how I understand it, this is the first time states have had an opportunity to come together and just talk about the act. How are you dealing with this? How do we approach this? Are we as efficient as we can be? All of those kinds of things.”

Page Walley, of St. Francis Ministries: “I think there’s a real hunger for more understanding around all this.” Photo courtesy of Facebook.

You can read all about the Family First Act here. In a nutshell: it expands the Title IV-E entitlement program, which currently pays for foster care and adoption, to include certain front-end services aimed at serving more families in crisis without the use of foster care. At the same time, IV-E funds for placements into group homes and other congregate care placements will be limited to two weeks.

Walley came over to St. Francis from Casey Family Programs, in part to lead the organization’s efforts to assist states with the Family First Act. In visits and meetings with “states from Florida to Oregon,” he said, “we saw questions that continued to bubble up.”

When Region Seven agreed to partner on a state convening, St. Francis used its notes from those conversations as “a guidepost” for the Region Seven meeting.

Youth Services Insider keeps hearing the same estimate of about 13 states planning to implement Family First by the October 2019 deadline, although at least one national membership group pegs it a little closer to 20. Information obtained by The Imprint through the Freedom of Information Act from ACF shows 17 states have notified them of an intent to delay, although an 18th state (Texas) has since shown us evidence that it also submitted a delay notice.

Three states planning to be ready in October are in Region Seven, according to Walley: Nebraska, Missouri and Kansas. Iowa has indicated plans to be ready by 2020.

YSI asked Walley what seemed to emerge from the convening as the most significant barriers, either at the region session or others. One point of great uncertainty, he said, is on ACF’s recent guidance on Family First being a “payer of last resort” – meaning if another federal funding stream can be used for services, even if those services are within the purview of Family First, it must be used.

“Where there’s some real opportunities for ongoing conversation is … where might Medicaid pick up and IV-E not pick up,” Walley said. “There’s some real questions about the process there,” as well as a need for “engagement with Medicaid offices.”

The Administration for Children and Families operates 10 regional offices that provide assistance to groups of states. Image courtesy of Department of Health and Human Services.

Other consistent concerns Walley has heard are about licensure of qualified residential treatment programs – clinical group care programs that will be exempted from new federal limits on congregate care – and the array of services that states will be able to tap into using the law’s foster care prevention services. Only models included on a clearinghouse of evidence-based programs will be allowed under the law – so far, none have been cleared and only 12 are currently being reviewed.

“There is some angst around what evidence-based programs will be on the clearinghouse list,” Walley said. “I think the intent of Congress is to have a lot more latitude than is currently provided with use of evidence-based practices.”

He refers there to a new bill introduced by Democrats on the Senate Finance Committee, which mostly attempts to ease the transition to Family First for states. Among its provisions: a permission structure for states to use services that are not on the Family First clearinghouse, but are acknowledged as evidence-based on other legitimate lists such as the California Evidence-Based Clearinghouse for Child Welfare or the federal clearinghouse for home visiting models.

Overall, Walley said he thought the Region Seven session was a worthwhile endeavor.

“It was the first such convening in a federal region, and that is something we thought would be beneficial, might be worth replicating,” he said. “I think there’s a real hunger for more understanding around all this.”

St. Francis is in discussions with another region on a similar convening now, and has responded with information to an inquiry from a different region, Walley said.

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