Young people involved in the child welfare system do best in families.
Family First Prevention Services Act
Signed into law on February 9, 2018, as a part of the Bipartisan Budget Act (HR. 1892), Family First includes long-overdue historic reforms to help keep children safely with their families and avoid the traumatic experience of entering foster care. In passing
the law, Congress recognized that too many children are unnecessarily separated from parents who could provide safe and loving care if given access to needed mental health services, substance abuse treatment or improved parenting skills.

Nearly half a million children are currently in foster care. After years of decline in numbers of children in foster care, the number has risen steadily since 2012, with anecdotal evidence and expert opinion linking this increase to the parallel rise in opioid addiction and overdoses. Family First provides struggling and overburdened child welfare agencies with the tools needed to help children and families in crisis, including families struggling with the opioid epidemic.
Young people involved in the child welfare system do best in families, in a safe and stable environment that supports their long-term well-being, according to research. The passage of Family First took a large step toward this vision by restructuring how the federal government spends money on child welfare to ensure that more children in foster care are placed with families. The law also provides more support for critical services, such as mental health and substance abuse treatment, in-home training and family therapy that can help prevent the need for foster care in the first place.
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The Family First Prevention Services Act (as part of Division E in the Bipartisan Budget Act of 2018 (H.R. 1892):
- Supports preventions services. The law gives states and tribes the ability to target their existing federal resources into an array of prevention and early intervention services to keep children safe, strengthen families and reduce the need for foster care whenever it is safe to do so.
- Provides support for kinship (relative) caregivers. Provides federal funds for evidence-based Kinship Navigator programs that link relative caregivers to a broad range of services and supports to help children remain safely with them, and requiring states to document how their foster care licensing standards accommodate relative caregivers.
- Establishes requirements for placement in residential treatment programs and improves quality and oversight of services. Allows federal reimbursement for care in certain residential treatment programs for children with emotional and behavioral disturbance requiring special treatment
- Improves services to older youth. Allows states to offer services to youth who have aged out of foster care up to age 23, along with adding flexibility to the Education & Training Voucher (ETV) program.
QUICK LINKS
Learn more about the the Family First Prevention Services Act:
Full text of legislation (Social Security Act language amended with Family First provisions)
DOCUMENTING THE HISTORY
Read the thank-you letters submitted by national advocates to members of Congress for their support in the passage of the historical legislation:
Article: The Key Players Behind Washington’s Biggest Foster Care Reform in Decades
“We know that federal policy shouldn’t create an incentive to rip these families apart. It should create incentives to keep families together.”
— Senator Ron Wyden, D-Oregon
The Family First Act provides a historic opportunity for stakeholders to re-envision the child welfare system and how it serves children and families.
Family First Implementation Timeline
The Children's Defense Fund produced a timeline relating to the various provisions of implementation of the Family First Act. Click on each item to expand. Download the PDF from Children's Defense Fund here > HHS will provide technical assistance, disseminate best practices, establish a clearinghouse, and collect data and conduct evaluations for the prevention services and programs. There is $1 million appropriated to HHS to carry out these provisions beginning in FY2018 and each year afterwards. [Sec. 50711(d)]
Title IV-E is renamed “Part E—Federal Payments for Foster Care, Prevention, and Permanency” and the purpose of Title IV-E is amended to reflect the new use of federal funds for prevention services and programs. (Sec. 50733)
The Adoption and Legal Guardianship Incentive Payment program is reauthorized for an additional five years, from FY2017 through FY2021. This takes effect as if enacted on October 1, 2017. (Sec. 50761)
*We assume the following provisions go into effect upon enactment:
- Amends the John H. Chafee Foster Care Independence Program by extending independent living services to assist former foster youth up to age 23 (previously for youth ages 18-21) and extends eligibility for education and training vouchers for these youth to age 26 (previously only available to youth up to age 23). (Sec. 50753)
- Amends the state plan requirement under Title IV-B, Subpart 1 to describe activities to reduce the length of time to permanency for children under age 5 and the activities the state undertakes to address the developmental needs of all vulnerable children under age 5 who receive services until Title IV-B or Title IV-E. (Sec. 50772)
- Requires the GAO to review states’ compliance with the various requirements of the Title IV-E Adoption Assistance “delink” and the savings and reinvestments that results from the federal reimbursement phase-in (Sec. 50782)
- Reauthorized a number of Title IV-B programs are for five years, from FY2017 through FY2021, including: The Stephanie Tubbs Jones Child Welfare Services Program (Title IV-B, Subpart 1), and the Promoting Safe and Stable Families Program (Title IV-B, Subpart 2), funding reservations for supporting monthly caseworker visits, and state Court Improvement Program Grants (Sec. 50752)
HHS will provide $5 million under Promoting Safe and Stable Families to help states develop electronic interstate case-processing systems. The funds will remain available through FY2022; HHS is required not later than one year after the final year that funds are awarded to
submit a report to Congress (available to the public) on the impact of the electronic interstate
case-processing systems. (Sec. 50722)
$8 million in competitive grants will be available to states and tribes to support the recruitment and retention of high-quality foster families to help place more children in foster family homes. The grants will be focused on states and tribes with the highest percentage of children in non-family settings. The funds will remain available through
FY2022. (Sec. 50751)
- The Court Improvement Program (CIP) in Title IV-B, Subpart 2, will need to include training for judges, attorneys and other legal personnel in child welfare about the new changes made to federal policy and reimbursement for children placed in settings that are not foster family homes. (Sec. 50741(c))
- States will need to establish as part of their health care services oversight and coordination plan procedures and protocols to ensure that children in foster care are not being inappropriately diagnosed with mental illnesses, disorders or disabilities that may result in the child not being placed with a foster family home. (Sec. 50743)
- States will need to collect and report data on children in child-care institutions or other settings that are not foster family homes. (Sec 50744)
- The Title IV-E Adoption Assistance income eligibility requirements for children under age 2 will be reinstated until June 30, 2024. In the interim, children with special needs under 2 years of age will continue to be eligible for Title IV-E Adoption Assistance if they meet the existing Title IV-E eligibility requirements or are eligible for state-funded Adoption Assistance payments. (Sec. 50781)
- HHS will release guidance on the practice criteria required for the prevention services or programs, and a pre-approved list of services and programs that meet the requirements of promising, supported, or well-supported practices. This guidance will be updated as often as necessary. (Sec. 50711)
- HHS will identify reputable model licensing standards for foster family homes. States will need to review how their standards compare to these standards and submit in their state plan to HHS why they are different if they are by April 1, 2019. (Sec. 50731)
- States can get Title IV-E reimbursement for up to 12 months for a child who has been placed with a parent in a licensed residential family-based treatment facility for substance abuse, regardless of whether the child meets the AFDC income-eligibility requirement for Title IV-E. (Sec. 50712)
- States can start receiving Title IV-E reimbursement for 50 percent of the state’s expenditures on kinship navigator programs that meet the evidence-base requirements of promising, supported, or well-supported practices, without regard to whether those services were accessed on behalf of children who meet the AFDC income-eligibility requirements for Title IV-E. (Sec. 50713)
- The 15-month time limit will be eliminated in the renamed “Time-Limited Family Reunification Services” program in Title IV-B. There will no longer be a time limit on reunification services for a child in foster care preparing to return home, and a child returning home will now have access to 15-months of family reunification services beginning on the date the child returns home. (Sec. 50721)
- The standards and grant amount for Regional Partnership Grants will be amended, including updates to the program that specifically address the opioid and heroin epidemic and updates the grant amount. RPGs are also extended for an additional five years (FY2017 – FY2021) (Sec. 50723)
- States will be required to document in their state plans for Title IV-B Child Welfare Services the steps they are taking to track and prevent child maltreatment fatalities. (Sec. 50732)
- States are required to have procedures for criminal records checks and checks of child abuse and neglect registries to be carried out on any adult working in group care settings where foster children are placed. (Sec. 50745)
- States will need to submit in their state plan to HHS how their licensing standards are in accord with the HHS’ model standards, and if not, why they deviate and a description of why that model standard is not appropriate for the state, whether and why they waive licensing standards for relative foster family homes and which ones, how the state trains caseworkers on the relative licensing waiver authority, and improvements the state is making in this area. (Sec. 50731)
- HHS will submit to the House Ways and Means and Senate Finance Committees a report on the National Youth in Transition Database and any other databases in which states report outcome measures relating to children in foster care and children who have aged out of foster care or left foster care for kinship guardianship or adoption. (Sec. 50753)
- Beginning October 1, 2019 (FY2020), states, tribes and U.S. territories will have the option to use Title IV-E funds, at a Federal Financial Participation (FFP) rate of 50 percent, for evidence-based prevention services and programs that are promising, supported, or well-supported. At least 50 percent of expenditures reimbursed by federal funds must be prevention services and programs that meet the requirements for wellsupported practices. States will be allowed to use Title IV-E funds for training and the administrative costs associated with developing the necessary processes and procedures for these services (including expenditures for data collection and reporting), based on a 50 percent reimbursement rate. These service, training and administrative costs are “delinked” from the AFDC income eligibility requirement for Title IV-E. (Sec. 50711)
- New restrictions on Title IV-E foster care maintenance payments for children not placed in 1) foster family homes, 2) Qualified Residential Treatment Programs, 3) settings for pregnant or parenting youth in foster care, 4) independent living settings for youth age 18 and older, or 5) settings providing high-quality residential care and supportive services to children and youth who have been found to be, or are at risk of becoming, sex trafficking victims. The group care settings will be ineligible for federally-reimbursed maintenance payments, but may receive Title IV-E administrative reimbursement. (Sec. 50741)
- **States have the option delay the effective date for up to two years; however any state that does so must also postpone seeking Title IV-E prevention investments for the same period of time. States will need to include in their state plan a certification assuring that the state will not enact or advance policies or practices that will result in a significant increase in number of youth in the juvenile justice system because of the new restrictions on federal reimbursement for children not placed in a foster family home. (Sec. 50741(d))
- HHS must submit to Congress a report on the results of the evaluation of state procedures and protocols to prevent inappropriate diagnoses of mental illness or other disorders resulting in the placement of children in group care settings, including their effectiveness and best practices. (Sec. 50743)
- HHS will issue a proposed rule on data exchange standards for improved interoperability that identifies federally required data exchanges; includes specification and timing of exchanges; addresses factors used to determine whether and when to standardize data exchanges; and specifies state implementation options and future milestones. (Sec. 50771)
- HHS will establish national prevention services measures, based on the data reported by the states, on certain indicators to measure the impact of and expenditures for the prevention services. This will be repeated annually thereafter, and reports on the state data made public. (Sec. 50711)
- New restrictions on Title IV-E foster care maintenance payments for children not placed in 1) foster family homes, 2) Qualified Residential Treatment Programs, 3) settings for pregnant or parenting youth in foster care, 4) independent living settings for youth age 18 and older, or 5) setting providing high-quality residential care and supportive services to children and youth who have been found to be, or are at risk of becoming, sex trafficking victims. The group care settings will be ineligible for federally-reimbursed maintenance payments, but may receive Title IV-E administrative reimbursement. (Sec. 50741)
- *States that took the option to delay the effective date of the restrictions on the Title IVE Foster Care Maintenance payments were prohibited from seeking Title IV-E prevention investments for the same period of time. States that take the prevention option to use Title IV-E funds for promising, supported, or well-supported prevention services and programs will be reimbursed at a Federal Financial Participation (FFP) rate of 50 percent. At least 50 percent of expenditures reimbursed by federal funds must be prevention services and programs that meet the requirements for well-supported practices. States will be allowed to use Title IV-E funds for training and the administrative costs associated with developing the necessary processes and procedures for these services (including expenditures for data collection and reporting), based on a 50 percent reimbursement rate. These service, training and administrative costs are “delinked” from the AFDC income eligibility requirement for Title IV-E. (Sec. 50711)
- GAO will submit to Congress a study evaluating the impact on the juvenile justice system resulting from the new restrictions on federal reimbursement for children not placed in a foster family home. (Sec. 50741(d))
- States, tribes and U.S. territories will be reimbursed at the Federal Medical Assistance Percentage (FMAP) for evidence-based prevention services and programs that are promising, supported, or well-supported. At least 50 percent of expenditures reimbursed by federal funds must be prevention services and programs that meet the requirements for wellsupported practices. States will be allowed to use Title IV-E funds for training and the administrative costs associated with developing the necessary processes and procedures for these services (including expenditures for data collection and reporting), based on a 50 percent reimbursement rate. These service, training and administrative costs are “delinked” from the AFDC income eligibility requirement for Title IV-E. (Sec. 50711)
- States will need to use an electronic interstate case-processing system for exchanging data and documents to help expedite the interstate placement of children in foster care, adoption or guardianship. U.S. territories, Indian tribes, tribal organizations and tribal consortiums are exempt from this requirement. (Sec. 507022)