The First Family First Act Prevention Plan Has Been Approved

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

The first state to have its plan for the Family First Prevention Services Act approved is … not actually a state! Not yet, at least.

The plan submitted by the District of Columbia’s Child and Family Service Agency (CFSA) has been approved by the U.S. Children’s Bureau (CB), the federal agency most directly responsible for child welfare policy and funding. CB is likely to review plans for 11 state systems this year, with the other 39 currently planning to delay implementation of the law by a year or two.

“In D.C. we really know prevention is the key and most families, I believe, want to be able to take care of their children,” said CFSA Director Brenda Donald, in an interview with Youth Services Insider today. “And sometimes things get in the way. And if we can help remove some barriers, always making sure kids are safe, everyone benefits.”

Family First was signed into law in February of 2018, as part of a stopgap spending bill to keep the government open. It permits states to use Title IV-E entitlement funds – previously reserved for foster care and adoption costs – for certain evidence-based services aimed at keeping families together in more child welfare cases. Candidates to be included on the list of services will be determined by a recently established clearinghouse.

The law also limits IV-E funding for group homes and other “congregate care” settings to two weeks, with some notable exceptions. States that seek a delay can hold off on the limits to congregate care funds, but cannot access the foster care prevention funds during that time.

In order to be cleared for the foster care prevention funding, states must submit a five-year, “IV-E Prevention Plan” that includes which evidence-based services it plans to use.

Washington, D.C., was by a mile the first system to submit its plan, sending its first version to CB in June. After several rounds of review, CB informed CFSA today that its plan was cleared for use.

In addition to D.C., the other systems that plan to implement Family First in 2019 are: Alaska, Arkansas, Kansas, Kentucky, Maryland, Nebraska, North Dakota, Utah, Virginia, Washington and West Virginia.

Five of those states have submitted plans for review already: Arkansas, Kansas, Kentucky, Maryland and Utah.

D.C.’s plan actually describes an entire prevention spectrum that includes some Family First models along with reunification services and upstream efforts to address family needs before maltreatment ever occurs. CFSA calls it the “Front Yard, Front Porch, Front Door” approach.

CFSA lists 22 different programs or service models on its plan, eight of which have either been approved or are under review by the clearinghouse:

  • Parents as Teachers and Healthy Families America, two versions of home visiting
  • Multi-Systemic Therapy
  • Trauma-Focused Cognitive Behavioral Therapy
  • Functional Family Therapy
  • Parent Child Interaction Therapy
  • Motivational Interviewing
  • Nurturing Parent Program

CFSA’s plan includes eight other programs it anticipates will eventually achieve a qualifying rating from the clearinghouse:

  • Chicago Parenting Program
  • Effective Black Parenting
  • YVLifeset
  • Transition to Independence
  • Project Connect
  • Recovery Coaches
  • Adolescent Community Reinforcement Approach
  • Parents Anonymous

Seven states have notified the U.S. Children’s Bureau of plans to delay on Family First until 2020, and an additional 32 states plan to delay until 2021. Washington State notified CB of a delay, but only until December of this year.

Of the 11 tribal systems with their own IV-E plans, five intend to implement this year and six have taken a delay.

Both chambers of Congress are poised to potentially move the Family First Transitions Act in hopes of enticing some additional states to move more quickly toward implementation of the law. The bill, a pared down version of the bill first introduced by Sens. Debbie Stabenow (D-Mich.) and Sherrod Brown (D-Ohio) over the summer, does three things:

  • A one-time, $500 million fund to help states prepare for the Family First Act provisions
  • A sweetener for states with a recently expired IV-E waiver, to help them cover anticipated short-term losses
  • A more lenient structure for the law’s evidence-based standards, at least for the first few years.

Donald said the transition bill would help D.C. shore up the more upstream prevention services it was partially using a IV-E waiver to conduct. The waiver enabled CFSA to expand the role and reach of community collaboratives, she said.

Donald said some of the services approved today are already fundable in D.C. under Medicaid, which per Family First regulations means Medicaid must pay for it.

“We know Family First [or IV-E] is the payer of last resort, even though Medicaid used to be,” she said. But CFSA will be able to bolster some programs with IV-E money “if we need more than the Medicaid-funded slots.”

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