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Family First- FAQ's


Children and teens involved in the child welfare system do best in families, where there is a safe and stable environment that supports their growth and well-being. Passage of the bipartisan Family First Prevention Services Act of 2018 (Family First) took important steps to realign federal funding to ensure children in foster care are placed with families and to prioritize critical supports, such as mental health and substance abuse treatment, in-home parent skill-based programs, and family therapy, that can help prevent the need for foster care in the first place. 

FFPSA promotes keeping children safely with their families while receiving evidence-based prevention services, like family preservation services, instead of placing children in foster care. In addition, FFPSA creates new standards to ensure that children only spend time in nonfamily or residential settings, known as congregate care, when necessary to address their treatment needs.

FFPSA creates these changes through key reforms:

  • Supports prevention services. FFPSA gives states the ability to target their existing federal resources into an array of evidence-based practice 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. It also requires states to document how their foster care licensing standards accommodate relative caregivers. Additionally, all evidence-based practice prevention services that are available to parents are also available to kin 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. It also requires six months of aftercare supports once the child leaves residential care to return home or to a foster family.
  • 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.



The law does not automatically roll out across every state; all states must begin implementation by October 2021. Each state will need to request to implement prevention programming under Family First and allocate state funds to leverage federal funding for this important purpose.



The prevention services are optional. The residential or group care reforms are not. States do have the option to delay implementation of the residential or group care reforms for up to two years. If they do, they also forgo their ability to participate in the law’s prevention services opportunity or risk loss of federal reimbursement for residential settings.



States need to prepare now to implement Family First. For prevention efforts, they’ll need to affirmatively opt-in for the opportunity to draw down federal funds in this new way to keep families safely together. These prevention services must be approved, evidence-based mental health and substance abuse prevention and treatment services, and in-home parent skill-based services, including parenting skills training, parent education, and individual/family counseling.

States also need to allocate state funds for that work. In order for a state to leverage a reimbursement opportunity of 50 percent of expenditures, at least 50 percent of those expenditures must be for well-supported evidence-based programs, rated such by the Title IV-E prevention services clearinghouse.

For residential or group care reforms, starting October 1, 2019, the law will allow for up to two weeks of federal funding for any foster care placement. After that, it will pay for placements only in the following settings:

1) Foster family homes;
2) Qualified Residential Treatment Programs (QRTP);
3) Settings for pregnant or parenting youth in foster care;
4) Independent living settings for youth ages 18 and older; and
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.

For that small but uniquely vulnerable population of children who have needs so significant they cannot be safely met in a family, Family First has created the QRTP model.



Those that develop and provide appropriate, effective prevention services based on the needs of children, teens, and their families.

Those that provide for families at risk of entering the child welfare system up to 12 months of mental health care; substance abuse and treatment services; in-home, skill-based parenting training; and family therapy. The law also extended time-limits for family reunification services.

Those that understand that to be effective, residential treatment programs need to be short-term, therapeutic, and high quality.



Currently, there are more than 300,000 youth in the foster care system with many states reporting some of the highest rates of child abuse and neglect in the nation, with a leading cause being parental substance abuse. Family First offers the opportunity to address the root causes of why children come into foster care, and to help their families heal.

Family First promotes family placements for children in foster care rather than residential settings like group homes. When children stay with their families, they are healthier physically and achieve more developmentally, attain higher education, and earn more income as adults than those who are placed in group homes. These youth can thrive when they are safe and healthy and have the support of a family.