The Family First Prevention Services Act What Residential Providers Need to Know Lisette Burton, J.D. Vice President, National Advocacy & Public Policy July 23, 2018
Agenda • Background on the Family First Prevention Services Act (FFPSA) • Overview of the Law • Answer to frequently asked questions • Opportunities and action • What’s happening in the field? • Wrap Up 2
Background What is the FFPSA? • While passage of this impactful legislation took some by surprise, advocates began work to pass this law several years ago. • The Family First Prevention Services Act was passed into law on February 9, 2018 as part of the Bipartisan Budget Act of 2018. • The law expands the use of federal Title IV-E child welfare entitlement dollars to prevent entry into foster care, and it restricts funds for out-of-home care that is not a foster family home. 3
Background What is the FFPSA? • While passage of this impactful legislation took some by surprise, advocates began work to pass this law several years ago. • The Family First Prevention Services Act was passed into law on February 9, 2018 as part of the Bipartisan Budget Act of 2018. • The law expands the use of federal Title IV-E child welfare entitlement dollars to prevent entry into foster care, and it restricts funds for out-of-home care that is not a foster family home. 5
Bipartisan Budget Act of 2018 Multiple Provisions Focused on Children & Families: – CHIP Reauthorization – extended for total of 10 years – Maternal, Infant and Early Childhood Home Visiting (MIECHV) Reauthorization for five years – Community Health Clinics reauthorized – Supporting Social Impact Partnerships to Pay for Results – Family First Prevention Services Act 6
Background What is the FFPSA? • While passage of this impactful legislation took some by surprise, advocates began work to pass this law several years ago. • The Family First Prevention Services Act was passed into law on February 9, 2018 as part of the Bipartisan Budget Act of 2018. • The law expands the use of federal Title IV-E child welfare entitlement dollars to prevent entry into foster care, and it restricts funds for out-of-home care that is not a foster family home. 7
Family First Prevention Services Act Parts 1-3 Prevention Activities Under I V-E (optional) • Funds child room and board when placed with a parent in a family residential substance abuse treatment facility • Funds promising, supported, and well-supported: – mental health and substance abuse prevention and treatment provided by a qualified clinician – In-home parent skill-based programs – How Long? • for up to 12 months – Who is eligible? • “Candidates for foster care” and pregnant or parenting foster youth. • Promotes kinship navigator programs 8
Family First Prevention Services Act Part 4 Ensuring the Necessity of a Placement that is not a Foster Family Home (mandatory) • After two weeks, only certain out-of-home care placements are eligible for federal reimbursement (per placement, not per foster care episode!) • 4 “Specified Setting” categories 1. Programs for pregnant/parenting youth 2. Independent living programs for youth 18+ 3. Programs serving youth who have been or are at risk of sex trafficking 4. New classification of residential intervention called a Qualified Residential Treatment Program 9
Family First Prevention Services Act Part 4 continued Qualified Residential Treatment Program (QRTP) • Must be licensed and accredited • “Qualified Individuals” (not employed by the state or affiliated with any provider) will need to conduct assessments and approve placement within 30 days • Judges will need to approve placement within 60 days and at regular status hearings • Clinical and Nursing staff will need to be onsite according to the treatment model and available 24/7 • Providers must maintain documentation of family engagement, including contact with siblings • Requires 6 months of post-discharge support and family-based aftercare 10
Family First Prevention Services Act Part 4 Ensuring the Necessity of a Placement that is not a Foster Family Home (mandatory) • After two weeks, only certain out-of-home care placements are eligible for federal reimbursement (per placement, not per foster care episode!) • 4 “Specified Setting” categories 1. Programs for pregnant/ parenting youth 2. I ndependent living programs for youth 18+ 3. Programs serving youth who have been or are at risk of sex trafficking 4. New classification of residential intervention called a Qualified Residential Treatment Program 11
FAQ: Do I have to become accredited?
FAQ: What does this mean for small group homes? Become a foster home? Become a QRTP? • Foster homes defined as: • New staff? – Home of an individual or • New treatment model? family • – This means that the term Are you trauma- may no longer include informed? “group homes, agency- operated boarding homes or • Can you become other facilities licensed or accredited? approved for the purpose of providing foster care… ” as • Who can you serve best? previously permitted in the regulatory definition at 45 CFR 1355.20(a) if that facility is not the home of an individual or family.
FAQ: Is there a size limit for providers of residential care? • The term ‘child-care institution’ means a private child-care institution, • or a public childcare institution which accommodates no more than 25 children, • which is licensed by the State in which it is situated * Watch out for the IMD Rule…
Impact • Depends on how the regulations are written – Impact will be different state by state – Prevention funding and out-of-home care limitations effective October 2019 - states can request up to a two-year delay by November 9th • New federal entitlement for prevention of entry into foster care – The opioid crisis is impacting child welfare systems nationwide – New state matching dollars are required • Access to the right care at the right time – Out-of-home care capacity is a challenge • Potential impact on continuums of care – Mental health – Juvenile Justice
What’s happening in the field? States are at varying points in the planning process – Examples: Colorado, Nebraska, Iowa, Louisiana, Florida, North Carolina – Many states are discussing a delay to allow time to plan State Budget Considerations Financial Support for Implementation Efforts – If funding were available, what would your priorities be? 16
What’s happening in the field? • Are you participating in an FFPSA workgroup led by your state child welfare agency? • Is your state or local provider association taking coordinated action regarding FFPSA? • Does your individual organization have a coordinated plan to influence and respond to FFPSA implementation? • Does your organization currently provide, or have interest in providing, mental health, substance use disorder, and/or in-home parent skill-based services that could help prevent entry into foster care? 17
Opportunities • Don’t forget about the Florida Quality Standards for Residential Care • Beyond the QRTP …how do you fit into your state’s continuum of care? • Mandated aftercare services should improve long-term outcomes for youth with greater needs • The field needs our collective expertise
Take action! • Track and inform rulemaking by HHS • Take part in implementation at the state and local level • Continue to educate staff and partners 19
Stay informed! Human Resources Subcommittee Hearing on The Opioid Crisis: Implementation of the Family First Prevention Services Act (FFPSA) Tuesday, July 24, 2018 at 10:00 AM 20
Contact information: Lisette Burton Lisette.Burton@boystown.org
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