Lost in the shuffle of the obvious and only news story going, the federal Prevention Services Clearinghouse has approved Homebuilders, a family preservation model with a large track record of success, for new federal funding under the Family First Prevention Services Act.
Homebuilders, which was developed in 1974 in Tacoma, Washington and as of 2017 was being used in 14 states, received the gold standard “Well-Supported” rating by the clearinghouse. The model deploys therapists with a caseload no higher than three to work with a family for up to six weeks. The interaction takes place in the home, and balances a parent-led discussion of family issues with delivery of supports aimed at addressing basic poverty-related barriers.
The top rating was based on two studies that the clearinghouse found to have strong integrity, one from the mid-1990s and another released in 2002. While the clearinghouse did not establish a link between Homebuilders and child safety – the 2002 study found no decrease in foster care placements attributable to the model – it identified seven favorable effects in the area of child permanency.
A review of research on family preservation in 2006 by the Washington State Institute for Public Policy found that “programs that adhere closely to the Homebuilders® model significantly reduce out-of-home placements and subsequent abuse and neglect. We estimate that such programs produce $2.59 of benefits for each dollar of cost.”
“Research shows Homebuilders has been well-supported for decades – now it’s official,” said Richard Wexler, executive director of the National Coalition for Child Protection Reform. “As a result, the Family First Act is a vastly more useful law than it was before.”
The Family First Act was passed in 2018 and for the first time permits the use of Title IV-E – an entitlement previously reserved for foster care and adoption costs – to be spent on mental health, substance abuse and parenting services meant to prevent the need for foster care in certain cases. But states can only draw down IV-E funds for services that meet the evidence-based thresholds in the law, and those decisions are made by the clearinghouse.
The clearinghouse deemed Child Parent Psychotherapy, a treatment that seeks to build a healthier connection between a young child and primary caregiver after a child has experienced trauma, as “Promising.” It rejected two candidates for inclusion:
- Solution Based Casework, a case management approach that uses “specific plans of action,” blocking a child welfare-involved family’s plan into family- and individual-level objectives.
- Family Behavior Therapy, can be used to address substance abuse issues of adults or of kids between age 11 and 17, and include a range of actions such as handling emergencies, ensuring household safety and financial management.
The new approvals brings the list of IV-E fundable prevention services to 15. The clearinghouse has signed off on 14, and the U.S. Children’s Bureau directly approved another – Family Centered Treatment – as part of Arkansas’ state plan for the Family First Act.
The clearinghouse is currently reviewing six models in the core areas of mental health, substance abuse and parenting. It is also reviewing a kinship navigator model used by the YMCA of San Diego County in California to connect relative caregivers with support and assistance.
Earlier this month, just as the coronavirus began to dominate headlines, the clearinghouse surprised many by rejecting a kinship navigator model used by Ohio. Some researchers close to the model suggested they might ask the clearinghouse to reassess the single study they believed could earn Ohio’s approach a Promising rating.
The clearinghouse process got off to a slow start after Family First was hastily pastsed in 2018 as part of a stopgap federal spending bill. The Trump administration has proposed bolstering the number of allowable services by waiving in approved models from two other well-known evidence-based raters: the California Evidence-Based Clearinghouse, and the federal registry of home-visiting programs.
John Kelly can be reached at email@example.com.