Renewed Family First Push Discussed for Summer

Youth Services Insider has learned that Senate Finance staff held a confidential conference call late last week with some child welfare advocates to discuss a possible reintroduction of the Family First Prevention Services Act, a bill that would significantly amend the federal IV-E foster care entitlement.

Family First blends the child welfare policy aims of Senate Finance Chair Orrin Hatch and Ranking Member Ron Wyden. Hatch years ago introduced legislation aimed at limiting the use of federal IV-E funds for congregate care and group home programs. Wyden had circulated a bill that enabled systems to spend IV-E dollars on interventions aimed at preventing the use of foster care in some cases involving substance abuse and mental health.

Becky Shipp and Laura Berntsen – who run point on child welfare for Senate Finance Chair Orrin Hatch and Ranking Member Ron Wyden, respectively – told participants that a move on Family First was targeted for June, but might be delayed if health care reform legislation drags on.

A key difference this time around, one participant on the call told YSI: there would be an opportunity for amendments to be considered. Last year, Family First was marked up quickly in the House, and then put up for unanimous consent in the Senate without ever being considered by the Finance Committee, whose leadership created the bill.

The bill was held up by several senators in the summer, and then again as its proponents sought to attach it to some year-end legislation in December.

One amendment likely to be submitted and approved, the participant said, is an amendment sought last year by Boys Town that softens the bill’s restrictions on federal funds for congregate care.

The amendment Boys Town sought in last year’s round on Family First would have altered a key piece of the bill’s constraints on congregate care: the definition of what the bill calls a “qualified residential treatment program,” or QRTP.

Qualified residential treatment programs are one of three exceptions to the bill’s proposed limits on federal IV-E contributions for congregate care placements. State and county agencies may only seek IV-E reimbursement for two weeks of congregate care unless the placement is a QRTP, a placement to assist pregnant or parenting foster youth, or a setting for young adults in foster care (age 18 and over).

Among the specified hallmarks of a QRTP, per Family First, is the presence of nursing and clinical staff during business hours and on-call at all times. The Boys Town amendment would alter this to permit staffing “according to the trauma-informed treatment model” being used by the provider.

YSI‘s initial question upon hearing of the meeting were whether Family First would be open to amendments by both chambers, and whether it would require a new round of scoring by the Congressional Budget Office (CBO). The budget neutrality of last year’s deal was contingent upon some rolling back of federal adoption funding, which we are now another year into. It also was built on assumptions about savings reaped from limits on congregate care spending, and those assumptions did not include the Boys Town Amendment.

Julia Lawless, communications director for Hatch, said those questions “are very premature.”

Said Lawless: “Chairman Hatch is continuing to work with colleagues in Congress to find a viable path forward for the measure.”

Between the Boys Town amendment and the push out of North Carolina to stop the bill last year, it seems pretty clear that this bill is not getting past the Senate without some easement on the congregate care restrictions. That decision is really going to rest with Hatch, who will have to relent on his central pursuit.

If it passes, our guess is that Trump would sign this bill in a heartbeat. He made the opioid epidemic an issue during the campaign, and has hosted White House talks on the issue since taking office. The front-end portion of this bill directly increases the resources for working with parents struggling with addiction.

Note: This article was updated on May 22 to better reflect the fact that this conference call included only selected advocates, who were asked not to discuss details of the call.

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John Kelly
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John Kelly is editor-in-chief of The Chronicle of Social Change.