Family First Act Becomes Law with Two-Year Budget Deal

What it means for Teaching-Family Model agencies in the U.S.

Since 2015, the Teaching-Family Association has been tracking and influencing “revolutionary” bi-partisan child welfare legislation known as the Family First Prevention Services Act (FFPSA), which would allow US federal Title IV-E funding to be used for “front-end” preventative services for children and families and would incentivize states to do so.

In 2016, the Teaching-Family Association received guidance that the FFPSA, after meeting with opposition in the Senate, was likely to pass only as part of a large, “omnibus” spending agreement where its language would not be as carefully scrutinized. We updated members in late 2016 when FFPSA language was added to one such agreement but ultimately removed. In the latest omnibus “budget deal,” FFPSA language was included, again, and passed into law.

This legislation will impact our member agencies in the US significantly. It is quite possible, however, that it will serve to benefit the Teaching-Family Association and its members.

Spirit of the legislation: The legislation provides federal support, for the first time, for prevention services designed to keep children out of the child welfare system and families together. The legislation provides new monies for in-home services and stipulates new requirements and limits for congregate care placements to incentivize states to reduce their reliance on low-quality congregate placements.

How it will impact our members: The area most likely to impact our members is the new definition of “Qualified Residential Treatment Program,” (QRTP) which would be exempt from strict limits on non-qualified congregate care placements.

To qualify as a QRTP, programs must:

  1. use a trauma-informed treatment model
  2. have registered or licensed nursing staff available 24/7 (not necessarily employed directly by the program, and where an “on-site” requirement accords to the treatment model used)
  3. facilitates and documents participation of family members in treatment program
  4. facilitates and documents outreach to family members of the child
  5. provides discharge planning and family-based care for six months post-discharge
  6. is licensed and accredited by COA, CARF, JCAHO or any other independent not-for-profit approved by the Secretary of Health & Human Services (HHS).

The Teaching-Family Association will communicate directly with HHS to be included, in the rule-making process, as an approved accreditation body as stipulated above. Burden falls on the HHS to prove why Teaching-Family Association is not equivalent to COA, CARF or JCAHO accreditation, otherwise it could be legally discriminatory.

Referrals to Qualified Residential Treatment Programs will have to come from qualified assessors who are not employed by the agency or placement setting, and they should use validated tools for assessment. There will be rigorous reporting regarding placements, as well, because one of the elements being considered is whether the placement can better be served through a foster family home.

Documenting specific treatment will be necessary—that’s easy for TFA agencies—as well as ongoing assessments of strengths and needs—also easy. These are actually areas where TFA agencies can do exceptionally well, and there are opportunities for TFA agencies to serve quickly without too much alteration or changes to meet the requirements of the legislation.

Opportunities for Teaching-Family Model Agencies

TFM Group Homes as QRTPs. In the HHS rule-making process, it will become more clear as to whether or not Teaching-Family Association agencies will be able to easily qualify as QRTPs—based on the language of the legislation, alone, we believe this will likely be the case.

TFM Group Homes as Foster Homes. By federal definitions, Teaching-Family Model group homes may be considered foster care placements if the homes have policies such that the number of children in a home may not exceed six (unless necessitated to accommodate sibling groups). While states may have their own regulations making this point somewhat sticky, as we have discussed in previous updates on this legislation, this legislation should incentivize states to consider exemptions or to otherwise re-define their own foster care laws to align with the federal definition.

New Funding for Home-Based Services. These programs need to be staffed by trained professionals and consist of in-home parent skill-based programs. Agencies must develop child prevention plans (for keeping children in the home). Services must be trauma-informed and in accordance with promising, supported, or well-supported practices. The practice should have a book or manual or other available writings that specify the components of the practice protocol and describe how to administer the practice. Teaching-Family Model in-home services tick all the boxes.

TFM Inclusion as Pre-Approved Practice. There will be lists of practices that are acceptable—the Teaching-Family Association will stay in the loop on all developments via the HHS to ensure the TFM’s inclusion.

Outcomes Tracking Should Support TFM Practice. This legislation further emphasizes tracking outcomes and the cost of services, looking at whether prevention services are cost-effective in preventing future foster care placements and if programs are expected to improve specific outcomes for children and families. The legislation further seeks to ensure programs have an implementation monitoring system in place and a focus on practice improvement—there should be an evaluation component. As outcomes are regularly measured and assessed by TFM programs, and these requirements are fulfilled by the TFM, we expect this to be a BIG opportunity for the TFM to be recognized as an exemplary program model in practice.

Further Considerations. TFA members should develop strong relationships with state regulators to acquire any necessary waivers… There will be $1 million in new grants made available for data collection focused on reducing foster care placement and increasing the use of foster care… Foster care payments will be made for children residing with parents in a residential family-based treatment facility for substance abuse—a potential opportunity for TFM agencies… There will be $5 million in new grants made available for development of an inter-state electronic case processing system design to expedite interstate placement of children and track their success and improvement. There will be new money tied to children affected by substance abuse and partnership grants to serve children in out-of-home placements (administered by Juvenile Court, primarily).

Next Steps for the Teaching-Family Association and Members

As mentioned above, the Teaching-Family Association will work to track influence the rule-making process and ensure the inclusion of Teaching-Family Association accreditation and the Teaching-Family Model in any HHS-approved lists of accrediting bodies and programs. TFA member agencies should work to track effects of this legislation at the state level and reach out to the TFA office with any pertinent state information.