Family First Clearinghouse Lays Out Its Process for Approving Services

The Prevention Services Clearinghouse will list all of the service models that can be used for preventing the use of foster care under Title IV-E of the Social Security Act.

The federal Office of Planning, Research and Evaluation at the Department of Health and Human Services has published a handbook that lays out how service models will be assessed for inclusion on the much-anticipated Prevention Services Clearinghouse, the gateway to funding under a recently passed federal child welfare law.

The handbook describes a six-step process that will be used to determine whether a program or model meets the evidence-base criteria in the Family First Prevention Services Act, which was passed in February of 2018 and mostly takes effect this October. Models that make the clearinghouse will have pole position for new federal funding under the law.

The Family First Act was passed in February of 2018, and will enable states to use the Title IV-E entitlement – previously reserved for foster care and adoption support – to fund services aimed at working with parents without the need for a family separation. Those services must be evidence-based and apply to three areas: parenting, substance abuse treatment and mental health interventions.

At the same time, the law restricts federal funds for the placement of foster youth in group homes and other “congregate care” options. States will only be able to draw funds for such placements for two weeks, with exceptions for programs that serve some niche populations and for accredited providers using trauma-informed, clinical models. Even in those cases, a judge will need to periodically approve the need for continued use of a congregate care facility.

States have the option to delay on the congregate care limitations until October 2021, but cannot use IV-E for the foster care prevention services until the delay ends.

Family First’s front-end services are limited to substance abuse, mental health and parenting interventions. And it is further restricted to models of services that are deemed to be promising practices or evidence-based interventions by the newly established clearinghouse.

The handbook released this month describes in detail the scrutiny that a model of service must undergo to be placed on the clearinghouse list. It begins with an identification of candidates to consider for review, which the handbook says will be an “inclusive process that invites recommendations from stakeholders, including states, to ensure broad coverage across program or service areas.”

The clearinghouse will then select and prioritize services for review, and begin a literature search to identify the universe of relevant research on those that are selected. All research will be screened to determine if it meets the quality control standards set forth in the evaluation standards for the clearinghouse.

Any studies that pass screening will be considered as part of an evidence review. Depending on how rigorous and extensive it is, each study will receive a rating of “high, moderate or low support of causal evidence.”

Ultimately, the studies that achieve “high” or “moderate” rankings will be used to assign one of four ratings: “well-supported,” “supported,” “promising” or “does not currently meet criteria.”

The handbook also describes a separate process for reviewing services, or considering new evidence that might elevate or lower their rating.

Family First projected a October 2018 launch of the clearinghouse, a year in advance of the start date for Family First’s two biggest changes. But the contract to actually build the clearinghouse (which went to Abt Associates) wasn’t even announced until that month. Now, with less than six months until Family First takes effect, states do not yet know what services will be fundable under the law.

There are 12 models currently under consideration by the clearinghouse – 10 related to the law’s three prevention areas, and two “kinship navigator” programs that are meant to assist relatives who have to temporarily take in a child while a loved one gets help under the law. In addition, a new law to help ease transition to Family First would give states some leeway to use models that are not on the Family First clearinghouse, but are rated for effectiveness elsewhere.

That law was introduced in late April by Sens. Sherrod Brown (D-Ohio) and Debbie Stabenow (D-Mich.), and is expected to be introduced with bipartisan support in the House this week.

A progress timeline circulated by clearinghouse operators says that the first list of services is expected this month. The process of reviewing new candidates will resume in “Late Spring-Summer 2019.”

Abt Associates will be hosting a webinar tomorrow about the clearinghouse handbook. Click here to register.


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John Kelly
About John Kelly 1135 Articles
John Kelly is editor-in-chief of The Chronicle of Social Change.