Family First Prevention Services Act (FFPSA) & HFA Home Visiting

The Family First Prevention Service Act (Family First) was signed into law on February 9, 2018 as part of the Bipartisan Budget Act of 2018 (H.R. 1892). Family First includes historic reforms to help keep children safe with their families and avoid the traumatic experience of entering foster care while emphasizing the importance of children growing up in families. There are two main components of the act, including a state option to use title IV-E funding for prevention services for eligible children and mandatory restrictions on title IV-E funding for congregate care (e.g., group care, residential care, etc.).

Now, under Family First, states can use these funds to provide prevention services and programs to families at risk of entering the child welfare system, allowing “candidates for foster care” to stay with their parents or caregivers.

Family First changes the federal financing structure for child welfare programming by allowing states, territories, and tribes the option of using federal title IV-E funds for prevention programs such as Healthy Families America, offering an opportunity for states to provide services to more families and prevent foster care system involvement. Previously, title IV-E funds, the largest source of federal funding for child welfare, could be used only to help with the costs of foster care maintenance for eligible children, program expenses, training, and other assistance costs.

In passing the law, Congress recognized that too many children are unnecessarily separated from parents who could provide safe and loving care if given access to needed programs and services.

Further, the Consolidated Appropriations Act of 2021 was signed into law, which, among other provisions, temporarily increases the federal reimbursement rate from 50% to 100% for the title IV-E Prevention Program, created under the Family First Prevention Services Act of 2018, for the duration of the COVID-19 public health emergency period (April 1, 2020 through September 30, 2021).

The act allows federal funds under title IV-E to support evidence-based prevention efforts. As of October 1, 2019, state child welfare agencies who have received approval from the federal government may claim reimbursement for three categories of evidence-based prevention programs:

• mental health services,
• substance abuse prevention and treatment services, and
• in-home parent skill-based programs. In-home parent skill-based programs include parenting skills training like Healthy Families America, parent education and individual and family counseling.

Services must be evidence-based – or shown to be promising, supported, or well-supported – and included in the State’s approved Prevention Plan, which must be developed and submitted by the state title IV-E agency. Funding can only be used in this capacity for 12 months at a time for children who are at imminent risk of entering foster care, their parents and relatives, and pregnant or parenting foster youth. Additional 12-month periods, with no limit, are allowable with redeterminations of eligibility and need by the child welfare agency.

Family First allows IV-E funding to be spent on prevention services for children and families to prevent children from entering foster care. Eligible target populations for evidence-based prevention services include:

• Children who are candidates for foster care and identified as being at imminent risk of entering foster care*,
• Parents or kin caregivers of candidates for foster care where services are needed to prevent the child’s entry into care or directly relate to the child’s safety, permanence or well-being, and
• Children in foster care who are pregnant or parenting. (Recognizing the unique needs of pregnant and parenting youth in care as well as the intergenerational nature of child welfare system involvement – including services for this population is a key opportunity for preventing child abuse and neglect.)

*Imminent Risk of Entering Foster Care is not defined in Family First. Each state will have to define the term for the purposes of the prevention services it provides under the new state option. We encourage state child welfare agencies to support broad state definitions and employ broad criteria, including child health, well-being, and economic stability outcomes when defining candidates for foster care.

There are a number of ways in which you can stay informed on how your state is responding to the opportunities within Family First. A few include:

• Connect with your state child welfare agency to see if your state plans to opt-in and develop a Prevention Plan under Family First.
• Ask your state agency to include HFA into any written Prevention Plan as a well-supported program.
• Seek out any state working group or stakeholder convening on Family First that you can join.
• Become familiar with any introduced or enacted legislation in your state.
• Educate your policymakers on HFA, the populations it serves, and the outcomes of the program model in areas impacting child and adult well-being, family functioning, and positive parenting practices.