Family First Prevention Services Act

Family First Prevention Services Act

The federal Family First Prevention Services Act (FFPSA) was signed into law in 2018. FFPSA enables states to use funds under Title IV-E and Title IV-B of the Social Security Act (SSA) to provide enhanced support to children who are at risk of entering foster care. The bill authorizes federal reimbursement of prevention services for up to 12 months. The bill also includes new restrictions on federal reimbursement for children placed in a nonfoster home. The National Conference of State Legislatures (NCSL) provides a more detailed explanation of the FFPSA, which can be found here: https://www.ncsl.org/human-services/family-first-prevention-services-act.

State Requirements

States may use Title IV-E funding of FFPSA to provide prevention services to a child who is a “candidate for foster care,” meaning a child who is at imminent risk of entering foster care but who can remain safely in the child’s home as long as services or programs are provided, a child whose adoption or guardianship arrangement is at risk of disruption or dissolution (SSA Section 475(13)), a child in foster care who is pregnant or parenting foster youth (SSA Section 471(e)(2)(B)), or parents or kin caregivers (SSA Section 471(e)(1)). Funding may also be used if a child is placed with a parent who is in a licensed residential treatment facility for substance abuse (SSA Section 472(j)).

Services provided must be trauma-informed, evidence-based programs offered by qualified clinicians within the specific categories of mental health, substance use disorder treatment, kinship navigator, and parent skill-building. In order to receive federal reimbursement, the Title IV-E Prevention Services Clearinghouse must rate the prevention services as either “promising,” “supported,” or “well-supported.”

Any service provided must meet the following general practice requirements:

• The practice has a book, manual, or other available writings that specify the components of the practice protocol and describe how to administer the practice;
• There is no empirical basis suggesting the practice constitutes a risk of harm to those receiving it when compared with its likely benefits;
• If multiple outcome studies have been conducted, the overall weight of evidence supports the benefits of the practice;
• Outcome measures are reliable and valid, and are administrated consistently and accurately across all those receiving the practice; and
• There is no case data suggesting a risk of harm that was probably caused by the treatment and that was severe or frequent.

States are required to collect and report information regarding each child for whom, or on behalf of whom, mental health and substance abuse prevention and treatment services or in-home parent skills-based programs are provided. This information must include the specific services or programs provided, the duration of services, the child’s placement status at the beginning and at the end of the one-year period, and whether the child entered foster care within two years after being determined a candidate for foster care.

Federal Payments

Prevention services are reimbursable at 50.0 percent from federal fiscal year (FFY) 2020 to FFY 2026. This includes allowable administrative costs necessary for the proper and efficient administration of the state plan, in addition to training costs for personnel employed or preparing for employment by the state agency or local agency administering the plan. Beginning FFY 2027, prevention services will be reimbursable at the applicable Federal Medical Assistance Percentages (FMAP) rate. Additionally, at least 50.0 percent of the amount paid to a state in any fiscal year must be for prevention services that meet the well-supported practice criteria.

Maintenance of effort is required for foster care expenditures. States electing to provide Title IV-E prevention services and programs must maintain the same level of state foster care prevention expenditures each fiscal year as the expenditure amount in FFY 2014. States must report state foster care expenditures for each fiscal year that a state participates in the Title IV-E prevention program. State foster care prevention expenditures include Temporary Assistance for Needy Families (TANF), Title IV-B, Social Services Block Grant (SSBG), and any other state or local agency funds used for prevention services and activities (SSA Section 471(e)(7)).

Approved kinship navigator programs are eligible for Title IV-E payments so long as the program is operated in accordance with promising, supported, or well-supported practices.

Other Changes Made by FFPSA

Additional changes made by FFPSA include:

• Requiring states to report on steps taken to track and prevent child maltreatment death;
• Limiting foster care maintenance payments to two weeks for placements that are not foster homes or qualified residential treatment programs (QRTP). QRTPs must have a trauma-informed treatment model, registered or licensed nursing staff on-site to the extent the program’s treatment model requires, facilitate outreach to family members, document family integration into the treatment process, and provide discharge planning and family-based care support for six months after discharge (SSA Section 472(k)(4)). A trained professional or licensed clinician must complete an assessment for each child placed in a qualified residential treatment center to determine if the placement is appropriate. The assessment must determine the strengths and needs of the child using age-appropriate, evidence-based validated functional assessment tools approved by HHS. A state will only receive federal payments on behalf of the child in a qualified residential treatment facility if the assessment is completed within 30 days. Additionally, if the assessment determines the placement in the QRTP is no longer appropriate, the child returns home, or the child is placed in a foster home or adoptive placement, federal payments will only be made on behalf of the child during the period necessary to transition the child home or to a new placement. The state will not receive any federal payment after 30 days of the determination that the placement in the QRTP is no longer appropriate; and
• Redefining the term “foster family home” to mean the home of any individual or family that is licensed or approved by the state where the foster child resides, adheres to the reasonable and prudent parenting standard, provides 24-hour substitute care for the child, and provides care for no more than six foster children (with some exceptions for parenting youth, siblings, meaningful relationships with a family, and special training) (SSA Section 472(c)).

FFPSA also makes the following changes to Title IV-B funding:

• Eliminates the time limit for family reunification services while in foster care and permits time-limited family reunification services when a child returns home from foster care (SSA Section 431(a)(7));
• Requires states to implement an electronic interstate case processing system for children in foster care, guardianship, or adoption by 2026 (SSA Section 471(a)(25));
• Provides grants in FFY 2018 for states to develop the electronic interstate case processing system (SSA Section 437(b)); and
• Reauthorizes regional partnership grants that work to alleviate substance abuse and support parents for five years. These grants can be used on a statewide basis and can be awarded to both nonprofit and state programs (SSA Section 437(f)).

Kansas Families First

States that chose to provide Title IV-E prevention services were required to submit a Prevention Services and Programs five-year plan as part of the state’s Title IV-E plan (SSA Section 471(3)(5)). In Kansas, the plan was submitted by the Department for Children and Families. It can be accessed here: https://www.dcf.ks.gov/services/pps/pages/ffpsa.aspx. The Kansas Department for Children and Families has awarded Families First Prevention Service grants to 12 community partners and stakeholders that provide programs in communities statewide.

In addition to the plan, Kansas is required to have a well-designed and rigorous evaluation strategy. The KU School of Social Welfare and the KU Center for Public Partnerships and Research (CPPR) have partnered with the Kansas Department for Children and Families to evaluate the Families First Program in Kansas. The most recent report can be found here: https://socwel.ku.edu/family-first-prevention-services-act.

by Amanda Prosser
Fiscal Analyst
785-296-7879