The Administration for Children and Families (ACF) has laid out a parallel track for states to clear services for the Family First Prevention Services Act, a new law that opens up uncapped federal dollars to prevent the use of foster care in some cases.
The program instruction from ACF describes in detail that path for a state child welfare agency to get “transitional payments” for services it wishes to fund under the new prevention services portion of Title IV-E, an entitlement that heretofore has been limited to supporting foster care placements or adoption subsidies.
The new front-end services are limited to substance abuse, mental health or parenting interventions, and only those that attain approval as being “evidence-based” by a newly established federal clearinghouse. If a service is not rated to be “well-supported,” “supported” or “promising” by the clearinghouse, a state cannot use IV-E to help pay for it. And of the allowed services a state uses, half of the dollars have to go to programs in the “well-supported” bucket.
The clearinghouse, which is being overseen by Abt Associates, has only reviewed 10 candidates thus far and has approved seven of them. Those decisions came out in late June, leaving states with just a handful of fundable options three months before the law takes effect.
Meanwhile, some states interested in moving quickly on the law are eager to gain approval for models and services that are already in play in their system. Kentucky, for example, is keen to gain clearance for the Sobriety Treatment and Recovery Team (START) program, which pairs parents with supportive mentors while they pursue addiction treatment. Washington would like to see its Family Access to Stabilization and Teaming (FAST) program get greenlit as part of a Family First plan.
On first read, the new process spelled out by the Children’s Bureau (CB) does not offer any way around the stringent evidence-based standards prescribed in Family First. It does offer a potentially faster pipeline to clear these programs while the clearinghouse gets off the ground.
“We intend that this process for transitional payments will support ACF’s goal to review programs and services as quickly as possible in the early years of implementation of the Title IV-E prevention program,” said the program instruction, which was signed by Children’s Bureau Associate Commissioner Jerry Milner.
The program instruction includes a workbook that must be completely filled out and included with its five-year Family First plan submitted to ACF by a state. The workbook walks an agency through documenting the programs it would like permission to fund with a IV-E match, and the evidence base showing those programs have had measurable impact on child welfare-related outcomes.
“The state must submit this checklist as part of the five-year plan, or as an amendment to an approved five-year plan by October 1, 2021,” according to the program instruction.
There is one notable exception in the standards for approval under the transitional payments. States will be able to include studies for consideration that are not randomized control or quasi-experimental studies. The clearinghouse requires one or the other though, so including studies that aren’t of either design could make it complicated when the service is actually up for official consideration.
If any state gains the temporary approval for a service, any other state can then draw transitional payments for that service as well. If the clearinghouse ultimately decides the service is not approved, IV-E payments would stop in the following fiscal quarter.
The Family First Act was passed in February of 2018. In addition to the new front-end services, the law restricts IV-E 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.
States have the option to delay on the congregate care limitations until October 2021, but cannot use IV-E for the foster care prevention services until the delay ends. So far, 10 states and the District of Columbia have told The Imprint that they plan to implement the law in 2019, and 29 states have indicated a plan to delay.
With the clearinghouse slow to develop, Children’s Bureau Associate Commissioner Jerry Milner informed stated weeks ago that they’d have an opportunity to make their case for services that could draw IV-E funding. This program instruction is the official guidance for that process.