Family First Clearinghouse Approves First Seven Services for Preventing Foster Care

The Family First Prevention Services Act requires the establishment of an evidence-based clearinghouse.

The IV-E Prevention Services Clearinghouse, which will be in charge of determining what can be funded under the Family First Prevention Services Act, has announced the first slate of options for states.

The website for the clearinghouse, which went live this week, lists seven services that meet the evidence-based standards of the law, and three that do not “currently meet the criteria.”

The Family First Act was passed in February of 2018, and mostly takes effect in October of this year. It enables 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.

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 established clearinghouse.

Approved services are given one of three rankings: Well-Supported, Supported and Promising. At least half of state spending under Family First will need to be on the services with a “Well-Supported” designation.

The seven approved services are as follows:

Families Facing the Future, Supported

This model is for parents with young or adolescent children, and who are receiving methadone treatment. The program includes a family retreat, and 32 parenting sessions conducted over a 16-week period (kids attend some of them, others are just parents).

Functional Family Therapy, Well-Supported

A family intervention model used with households that include an adolescent exhibiting conduct disorder, substance abuse or is acting out violently.

Multisystemic Therapy, Well-Supported

Seeks to promote pro-social behavior and curb criminal activity and illicit substance abuse among 12- to 17-year-olds.

Parent-Child Interaction Therapy (PCIT), Well-Supported

A model to serve families with young children who exhibit behavioral or parent relationship problems. PCIT imparts play therapy skills for parents to use with their children.

Trauma-Focused Cognitive Behavioral Therapy (CBT), Promising

This version of CBT is designed to serve children with an established history of trauma who are experiencing sexual behavior problems and post-traumatic stress disorder.

Parents As Teachers, Well-Supported

A home-visiting model that uses trained parent educators to work with new and expectant mothers.

Nurse-Family Partnership, Well-Supported

A home-visiting model that pairs new moms with professional nurses before and after pregnancy.

The clearinghouse did not approve Multisystemic Therapy for Child Abuse and Neglect, a family therapy intervention to be used when a family comes to the attention of child protective services.

It also did not approve either of the first candidates for support under the law’s Kinship Navigator provision: Kin-Tech, a Florida-based model, and the model used by the Children’s Home Society of New Jersey.

Kinship navigators are designed to connect relatives caring for the children of their loved ones with benefits, support and training. Family First offers a 50 percent match to fund navigator programs, but only if they are deemed to be “evidence-based.”

The clearinghouse appears to have not yet made a decision on three services, which are still under review:

  • Healthy Families America, a widely used home-visiting model.
  • Methadone Maintenance Therapy, a medication-assisted treatment for addiction.
  • Motivational Interviewing, a strategy aimed at resolving ambivalence around trying to address substance abuse issues, and fostering the motivation to do so.

The clearinghouse is overseen by Abt Associates.

Because the clearinghouse has been delayed in rolling out approved services, the Department of Health and Human Services recently announced that it would give states a direct line to seek approval for services that were not yet formally approved.

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