The Family First Prevention Services Act (FFPSA) Crystal Ward Allen, MSW, LSW Strategic Consulting Casey Family Programs

Family First Prevention Services Act of 2018 P.L. 115-123 passed as part of the Bipartisan Budget Act in Feb, 2018. New option for States and Tribes to claim Title IV-E funds for prevention activities as early as October 1, 2019. New policy to ensure appropriate placements for children in out of home care as early as October 1, 2019. New funding and reauthorization of existing funding for child welfare programs including adoption incentives funding, prevention funding, court funding, and specific substance abuse prevention grant funding.

Overview FFPSA Purpose Title I: Placement Prevention Services Title II: Ensuring Appropriate Placements Other provisions Ohio FFPSA activities

The WHY behind FFPSA Preserving families – “family” first Systemically addressing substance use/opioid issues Getting investments right – opening up Title IVE for placement prevention services Paying for what works/evaluate programs to make sure they're effective (EBPs – evidence based practices) Children in foster care have the right to be placed in the “least restrictive” setting relative to their needs Children do best in a family-like setting. When a child can’t be safely placed in a family-like setting, ensuring quality treatment options

PLACEMENT PREVENTION SERVICES Title 1 PLACEMENT PREVENTION SERVICES

Optional Placement Prevention Services New 50% federal reimbursement for EBPs: Mental health treatment services Substance abuse prevention and treatment services In-home parent skill-based programs that include parenting skills training, parent education and counseling

Evidence Based Practice ACF named Abt Clearinghouse to rate programs re evidence – more guidance to come Promising, supported, well supported… Currently few child welfare programs CA Evidence Based Clearinghouse SAMHSA others

Prevention Services for Children & their Families… Services for up to 12 months to: A child who is a “candidate” for foster care A child in foster care who is pregnant or parenting A parent or kin caregiver of the child Placement prevention services are without regard to family income! (vs 1996 AFDC standards that apply for fed $ for out of home care)

New Funding for Prevention Activities 50% Reimbursement rates Increases to State FMAP (Ohio’s is 63%) in 2026 Half the spending in every fiscal year must be for well-supported practices 50% Reimbursement also for related Training & Admin Non-supplant and MOE requirements

Who is a “Candidate for Foster Care?” Ohio will need to define clearly with feds Congressional language somewhat soft Basically child at risk of coming into care without “placement prevention services” for them, their parents, their kinship caregiver Also to prevent disruption after reunification, legal custody or adoption

Ensuring appropriate placements in foster care Title 2 Ensuring appropriate placements in foster care

Valid Placement Settings for Federal Payment Licensed foster homes with live-in parents – no shift work – up to six children or youth Group care not requiring QRTP standards prenatal, postnatal or parenting supports for youth Supervised independent living for youth >18 “High-quality residential care and supportive services” to youth who are, or are at risk of becoming sex trafficking victims QRTP - Qualified Residential Treatment Program

Community Based Service Needs for High Need Children & Youth Supporting families - Birth/Adoptive, Kin-caregiver, Foster families Physical & Behavioral Healthcare services Developmentally Disabled services Educational Services for students Community & Prevention Services Additional Treatment / Therapeutic Foster Caregivers recruitment needed

Qualified Residential Treatment Program (QRTP) – Assessment & Timing After 14 days in residential, no fed funding unless the following occurs: Assessment of youth required within 30 days of placement (independent 3rd party assessment) Court oversight of placement decision, including review of assessment indicating residential, within 60 days Ongoing court review of assessment of needs & strengths during residential stay State director must review/track placements beyond 12 months, or 6 months for children under age 13 There are no time limits on how long a child or youth can be placed in a QRTP as long as assessment indicates treatment needs and services

Qualified Residential Treatment Program (QRTP) – new Standards Trauma informed treatment model Registered or licensed nursing and other licensed clinical staff onsite, consistent with the QRTP’s treatment model. Facilitated outreach & engagement of the child’s family in the child’s treatment plan Provides discharge planning and family-based aftercare supports for at least 6 months Licensed and accredited (COA, JCAHO, etc.)

Ensuring Appropriate Placements in Foster Care Implementation of QRTP provisions required between Oct 1, 2019 and Oct 1, 2021. States can’t implement Prevention Services provisions before QRTP (this is an option). Also, $8 million nationwide for foster care recruitment & retention

Other provisions

Opioids and other Drugs Title IV-E reimbursement can cover infants / children in Residential treatment with their caregiver Residential Family Based Substance Use Disorder Treatment – evidence shows effective outcomes – sobriety, intact families, safety! Think MOMS Ohio START (Sobriety, Treatment & Reducing Trauma Maryhaven, Amethyst/Alvin House, Stepping Stones Must be Trauma informed, address Parenting Skills Effective October 1, 2018 – without regard to family income Plus CURES, SOR, more…

State Plan to Reduce Child Maltreatment Fatalities State to compile complete and accurate data on child deaths due to abuse or neglect State to develop a statewide plan to prevent maltreatment fatalities Public and private agency partners including public health, law enforcement and the courts to be involved

Consider…TRAIN Timely Recognition of Abusive Injuries OCHA – 6 Children’s Hospitals Several Pediatric Practices & some regional hospitals “Sentinel” Injury -- specialized physical exam & bundle of care protocol -- report to child welfare Infants more likely to return w new injuries OCHA, Casey & ODJFS working to assist with matching Sentinel Injury children w child welfare data – report, services, repeat maltreatment

Kinship Navigator Programs 50% Reimbursement for Kinship Navigator programs Ohio has experience, value, bill pending (HB126, $5M, passed House, on to Senate) Must be evidence based Fed grant awards for evaluation

Model Foster Parent Standards HHS issued model foster parent licensing standards ODJFS, OCA, PCSAO all provided comments Builds on Ohio Foster Parent Licensing Committee work last spring States to implement pertinent plans April 2019

Continued Child Welfare Funding Reauthorizes Title IV-B programs and services until FY 2021 Stephanie Tubbs Jones Child Welfare Services Program Promoting Safe and Stable Families Program Court Improvement Program Regional Partnership Grants re Substance Abuse Improves child placement process across state lines – NEICE Reauthorizes (& a few changes) the John H. Chafee Foster Care Independence Program until FY 2021. Reauthorizes Adoption Incentive Program Delays a final Adoption Assistance de-link for infants

OHIO Response Five Regional Exploration and Design Sessions in October 2018 Leadership Group (cross system) to consider input, assess, plan to implement ODJFS submitted intent to delay QRTP implementation past Oct 2019 (not sure when) MUCH partnership needed

Thank you! Questions? Crystal Ward Allen CWardAllen@Casey.org