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

2. Family First Prevention Services Act of 2018
P.L 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.

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

4. 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

5. PLACEMENT PREVENTION SERVICES
Title 1
PLACEMENT PREVENTION SERVICES

6. 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

7. 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

8. 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)

9. 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

10. 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

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

12. 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

13. 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

14. 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

15. 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.)

16. 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

17. Other provisions

18. 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…

19. 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

20. 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

21. 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

22. 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

23. 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

24. 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

25. Thank you!
Questions?
Crystal Ward Allen