The new clearinghouse for the Family First Prevention Services Act has approved another parent support program and a substance abuse treatment model.
Methadone Maintenance Therapy (MMT) uses medically-prescribed methadone to reduce the use of heroin and other opioids by people struggling with addiction and dependency. Its inclusion on the original list of programs for review was an early indicator that the clearinghouse was taking a broader view of evidence-based outcomes than just child welfare metrics (i.e., new substantiated reports of maltreatment or subsequent entry into foster care).
Of the 47 studies of MMT considered by the clearinghouse, 20 were deemed eligible for review; one received a “high” rating and one received a “moderate” rating. Those studies showed MMT had favorable effects on parent or caregiver drug use.
Healthy Families America (HFA), a home visiting program, received the clearinghouse’s highest rating: Well-Supported. HFA uses home visiting professionals trained to help prepare new or expectant families for parenting, with biweekly visits before birth and weekly visits for at least six months after birth.
HFA has an odd mix of ratings on the California Evidence-Based Clearinghouse (CEBC). As a model for “child well-being,” CEBC also 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 CEBC’s lowest rating possible: “Evidence Fails to Demonstrate Effect.”
HFA joins two other home visiting models on the clearinghouse’s list. Nurse Family Partnership and Parents as Teachers, both also received a rating of Well-Supported.
The addition of the two programs bring the total number of approved Family First options to nine. The clearinghouse website launched with an initial list of seven services in late June– of the original review list, the highly-regarded Motivational Interviewing model is the only one that has yet to receive a rating.
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.
At the same time, the law restricts federal funds for the placement of foster youth in group homes and other “congregate care” options. States will only be able to draw funds for such placements for two weeks, with exceptions for programs that serve some niche populations and for accredited providers using trauma-informed, clinical models. Even in those cases, a judge will need to periodically approve the need for continued use of a congregate care facility.
Family First’s front-end services are limited to substance abuse, mental health and parenting interventions. And it is further restricted to models of services that are deemed to be promising practices or evidence-based interventions by the established clearinghouse, although the Administration for Children and Families recently announced a short-term, fast-track system for approval while the clearinghouse starts to build its roster.