The Family First Prevention Services Act offers states the chance to tap federal funds to prevent the need for foster care in some child welfare cases. At the same time, it greatly limits the amount of federal money that can be used to put foster youth in group homes, institutions and other “congregate care” options.
At least one state has studied the new restrictions on group placements, weighed them against the potential foster care prevention funds, and decided to just stop seeking federal dollars for congregate care altogether.
Alaska plans to cease most claims for congregate care placements under Title IV-E, the child welfare entitlement program that currently reimburses states for at least half of those costs. By dropping federal claims for congregate care, the state avoids the need to craft a plan for complying with the more complicated rules on IV-E claims in that area.
Here is the gist.
The Family First Act was passed in February of 2018, and mostly takes effect in October of this year. It enables states to use the Title IV-E entitlement – previously reserved for foster care and adoption support – to fund services aimed at working with parents without the need for a family separation. Those services must be evidence-based and apply to three areas: parenting, substance abuse treatment and mental health interventions.
On the back end of the system, states will only be able to draw federal funds for group home placements for two weeks. There are notable exceptions for programs that serve some niche populations – pregnant youth and young adults in care, for example – and for accredited providers who meet a newly established standard of Qualified Residential Treatment Program (QRTP). But even in those cases, a judge will need to periodically approve the need for continued use of a congregate care facility.
QRTPs will likely be the biggest exception to the new limits, and there is considerable angst in some states about the time and expense of moving some of their congregate care providers toward compliance with this standard. For many, it will require some significant changes, including national accreditation and the planning of aftercare services for youth who are discharged from the programs.
The Family First Act mostly takes effect in October of 2019, but states are permitted to seek a delay of up to two years. Thus far, at least 29 states have made their intention to delay known.
Alaska has basically decided that it’s better for its Department of Health and Social Services (DHSS) to just absorb the full cost of its congregate care needs, and start drawing down Family First funds this year.
“Alaska’s child welfare program has one of the lowest per capita rates of children and youth placed in residential settings in the nation,” said DHSS spokesman Clinton Bennett, in an e-mail to The Imprint. “Due to the relative low numbers of youth who require this level of care in Alaska, compliance with the requirements would be more expensive and burdensome for the state and its providers than the alternative – to not claim the maintenance payment for this population.
“Effective October 2019, Alaska is choosing to not claim the maintenance payment for youth in residential care whose stay exceeds two weeks in this setting, therefore the requirements do not apply.”
According to the most recent federal data from the Adoption and Foster Care Analysis and Reporting System (AFCARS), Alaska is indeed tied for lowest use of congregate care. Just 4 percent of the state’s foster youth were in group settings, the same rate as Nevada and Hawaii.
Youth Services Insider has heard that a few other states are considering a similar strategy to simplify and maximize compliance with Family First. It calls attention to the true calculus of potential cost burden for states, which is, how much of existing congregate care costs are successfully claimed under IV-E and funded by the federal government?
There are other significant costs and complexities to setting up a Family First-compliant system, but the IV-E portion of congregate spending is the real point of uncertainty for states. And as far as YSI can tell thus far, it is fairly difficult to get at exactly what the federal share is.