The Family First Prevention Services Act: A Mixed Bag of Reform

Earlier this month, the federal Family First Prevention Services Act (H.R. 5456) was finally introduced after more than a year of hearings and behind-the-scenes work by Congressional staff. The bill has two main purposes: to bolster federal investments to prevent entries into foster care, and to reduce the number of children and youth who are placed in congregate care settings.

With a limited number of remaining legislative days this session due to the elections, the House and Senate are taking a “damn the torpedoes” approach and attempting to fast track the bill through each chamber. In fact, the House Ways and Means Committee cleared the bill for a vote on the House floor just five days after the legislative text was made public.

This expedited process has left states and advocates precious little time to analyze the bill and weigh in. This is particularly problematic considering the bill’s shortcomings.

But let’s start with what the bill does right.

Under current law Title IV-E Foster Care funding, a federal entitlement, only kicks in after a child is removed from their parents due to maltreatment. Most of us in the advocacy community have long supported expanding the child welfare entitlement to provide supportive services to at-risk families before removal becomes necessary.

This bill advances that goal, but in a very limited way. The bill does allow for IV-E funded services to be provided to families pre-removal. Unfortunately, in order to become eligible, families must be deemed to be at “imminent risk” of having their children removed to foster care. Despite including the word “prevention” in its title, by only providing an entitlement to supportive services when families have reached that level of crisis, the bill isn’t really funding prevention at all.

What we’re actually talking about here is early intervention, which, as I’ve recently argued is routinely mislabeled as prevention.

Furthermore, because the bill fails to comprehensively address the Title IV-E “lookback,” it runs the risk of incentivizing diversion from foster care. Federal funding for the new pre-removal services is available to all families that meet the definition of “imminent risk,” while IV-E foster care payments are only available to children whose parents meet outdated income standards.

So states could claim federal reimbursement for the new in-home services, but for half their children (those who aren’t IV-E eligible under the lookback), they wouldn’t be able to draw down federal dollars for foster care. Federal oversight will be needed to ensure that states don’t compromise child safety by leaving children in dangerous homes because it is fiscally convenient. Even better, Congress and advocates should make a full de-link of Title IV-E a priority.

The ability of the bill to achieve its stated goals is also limited by political considerations. Due to the unwillingness of Congress and many in the advocacy community to commit to investing additional resources in child welfare, the bill was designed to be cost-neutral. Accordingly, the scope and duration of services that families are entitled to under the bill was significantly pared down from the original proposal introduced by Senator Ron Wyden (D-Ore.).

Still, H.R. 5456 does make progress in creating a federal entitlement to qualifying families for three sets of services: mental health, substance abuse, and support for the development of parenting skills. If providing access to federal funds supports states in developing programs that can address these issues to stabilize families while still keeping children safe, that would be a major victory in and of itself. And, hopefully, it would motivate a further expansion of the entitlement to a broader range of family support services available well before situations deteriorate to the point of “imminent risk.”

As I’ve noted before, one of the major flaws in the current conversation about federal child welfare reform is that it‘s often predicated on an assumption that prevention and early intervention can be financed by redirecting funding currently spent on children in out-of-home care. Unfortunately, the Family First bill is built on this shaky premise.

To finance this expansion of IV-E services, the bill haphazardly cuts federal funding for certain congregate care placements and delays implementation of a provision in the 2008 Fostering Connections to Success and Increasing Adoptions Act that expanded access to the adoption assistance subsidies for parents who adopt young children with special needs out of foster care.

As Congressman Lloyd Doggett (D-Texas) noted during the Ways and Means Committee markup, “all this money is taken from another program,” calling it “robbing Peter to pay Paul.”

The congregate care restrictions in particular have been controversial and problematic from the beginning. The bill seeks to reduce or eliminate the use of non-therapeutic congregate care settings – generally referred to simply as group homes – by establishing a new definition of “qualified residential treatment program” with much higher program standards.

Unfortunately, the new definition is extremely limited and promotes a strict medical model. Meanwhile, all other programs classified as congregate care would, beginning in 2019, be ineligible for federal funding for any placement lasting longer than two weeks. This includes a number of programs that have been developed to serve unique populations and needs, such as group homes that serve youth with behavioral challenges that cannot be safely addressed in a foster home, and youth who are involved with the juvenile justice system for whom group homes are less restrictive than alternatives like locked detention centers.

These programs would no longer be eligible for federal funds under H.R. 5456. There are just two exceptions written into the bill: programs designed to support pregnant and parenting teens, and independent living programs for youth age 18 and older.

In California, these new restrictions would, ironically, eliminate federal support for a successful program that was developed as an alternative to group home care. The Transitional Housing Placement Program (THPP) serves 16- and 17-year-olds who haven’t been successful in family settings, but don’t need the level of supervision provided in congregate care.

Youth are provided with intensive independent living skills development while living in supportive community settings. Because it lumps this program in with group homes, H.R 5456 would eliminate federal funding for THPP.

Furthermore, the bill does nothing to develop alternative placements for the youth who are generally placed in congregate care. These foster youth tend to be older and are far more likely to have mental or behavioral health challenges than their peers in family-based foster care. Simply shutting down current group home programs without providing a suitable alternative sets these young people up for further placement disruptions, and increases the risk that they will run away or become involved in the juvenile justice system.

In California, our state shares the goal of reducing the use of congregate care and supporting children in families whenever possible. However, California has embarked on a much more intentional and comprehensive approach, known as the Continuum of Care Reform (CCR).

CCR recognizes the importance of building capacity in the community to serve youth who are currently residing in group homes. This involves increasing investment in foster parent recruitment and retention; providing better supports to foster and kin parents while children are placed in their homes; developing specialized and therapeutic foster homes; and expanding access to community-based mental and behavioral health support services.

In the final analysis, expanding the entitlement to increase the availability of mental health, substance abuse, and parent skill-development services before a child is removed is a significant achievement. And fortunately as the bill’s dubious provisions regarding congregate care don’t go into effect until 2019, there is time for Congress to revisit the issues and revise their strategies.

If I were in Congress, I would probably only vote for H.R. 5456 if I secured a commitment from my colleagues to fixing its problems and filling in the gaps next year. The bill’s goals are laudable and shared by all of us in the advocacy community, but as California has demonstrated, there is a better approach.

Sean Hughes is a managing partner at the consultancy firm Social Change Partners. Over the past few months, he has contributed to a series of pieces in The Chronicle about child welfare finance reform. We encourage readers to submit their own commentary and analysis on the subject.

Click here to read all of The Chronicle‘s continuing coverage of the Family First Prevention Services Act.

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