Family First: Keeping Children Safe at Home


The U.S. House Ways and Means Committee marked up the Family First Prevention Services Act, which allows states to use federal child welfare matching funds for certain quality prevention investments for children and their parents and encourages the placement of children in foster care in the least restrictive, most family-like settings.
This bill is significant because funding for child welfare prevention to help keep children safely at home is capped under current law, while foster care payments are not.  This bill would take a significant first step towards providing matching funds for specified prevention services and programs. 
Funding would be available for two types of prevention services and programs: 
1.  Mental health and substance abuse prevention and treatment services. 
2.  In-home parent skill-based programs, which include parent skills training, parent education, and individual and family counseling.
The bill makes these services available to children who are candidates for foster care, without regard to income. Specifically, children must have a prevention plan identifying them as being at imminent risk of entering care but who can safely remain at home or in a kinship placement if provided services that prevent entry into foster care.  Services can also be provided to children in foster care who are pregnant or parenting, and to the parents or kin caregivers of candidates for foster care where services are need to prevent entry into care and directly relate to the child’s safety, permanence or wellbeing. The bill specifies that services are available for a maximum of 12 months, but can be received more than once throughout different points in the child and family’s life.
These provisions are important because parental mental health and substance abuse are significant risk factors for children—but treatment has been shown to be effective.  States that expanded Medicaid eligibility under the Affordable Care Act also have additional capacity to provide prevention services because of the mental health and substance abuse services available through Medicaid. While Medicaid has the potential to reach much larger populations of at-risk parents and children than the specific group targeted by the Family First Prevention Services Act—and states should be acting now to take advantage of that potential—the new flexibility would allow states to develop more intensive, comprehensive programs for these specific families, including non-health components that go beyond what can be funded under Medicaid.  
The cost of the new services would largely be offset by reductions in states’ ability to claim federal payments for putting children in inappropriate non-family foster settings, such as group homes and congregate care settings, which are less desirable options than family placement.  
This bill is not a comprehensive child welfare reform bill—in particular, it leaves federal foster care eligibility tied to the pre-welfare reform Aid to Families with Dependent Children (AFDC) eligibility standards, which means that fewer and fewer foster care cases qualify for federal funding each year.  However, the bill is an important step towards the goal of investing in prevention of harm to children and reducing the need for more costly later interventions.
The Family First Prevention Services Act was introduced with bi-partisan, bi-cameral support and was approved by the Ways and Means Committee. Let’s urge Congress to pass this bill.

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