The Evolution of Federal Child Welfare Policy through the Family First Prevention Services Act of 2018: Opportunities, Barriers, and Unintended Consequences

• Date: 01 November 2020
• Author: David Kelly,Mark F. Testa
• Published date: 01 November 2020
• DOI: 10.1177/0002716220976528

68 ANNALS, AAPSS, 692, November 2020

DOI: 10.1177/0002716220976528

The Evolution

of Federal

Child Welfare

Policy through

the Family First

Prevention

Services Act of

2018:

Opportunities,

Barriers, and

Unintended

Consequences

By

MARK F. TESTA

and

DAVID KELLY

976528ANN The Annals Of The American AcademyFederal Child Welfare Policy And Family First

research-article2020

The Family First Prevention Services Act of 2018

affords child welfare agencies a new opportunity to fund

evidence-supported interventions to prevent children’s

removal into public foster care and ensure that youth in

care receive appropriate treatment in the least restric-

tive (most family-like) setting. The new law has been

generally heralded as a much-needed improvement

over prior funding constraints, but there are concerns

among a growing number of child welfare leaders,

researchers, professional membership organizations,

and advocacy groups that its focus on the families of

children who are at immanent risk of removal because

of maltreatment is too limiting and that overreliance on

strict evidence standards may contribute to racial dis-

parity. This article considers how child welfare agencies

can best leverage the opportunities presented by Family

First while addressing potential barriers posed by the

paucity of evidence-supported prevention programs and

avoiding the unintended consequences of limiting reim-

bursement to only selective prevention services that

meet rigorous evidence standards of effectiveness.

Keywords: child welfare history; prevention of foster

care; evidence-supported interventions;

primary prevention of child maltreatment

The Family First Prevention Services Act

(Family First) of 2018 affords child welfare

agencies a new opportunity to fund evidence-

supported interventions to prevent children’s

removal from their homes and placement into

public foster care and to ensure that youth in care

receive appropriate treatment in the least restric-

tive (most family-like) setting. There is general

agreement among the child welfare community

that the expansion of the federal Title IV-E enti-

tlement program beyond reimbursement for

Mark F. Testa is a distinguished professor emeritus at

the University of North Carolina School of Social Work

at Chapel Hill. He is an elected fellow of the American

Academy of Social Work and Social Welfare and is

nationally recognized for his scholarship and public

engagement in child welfare reform.

Correspondence: mtesta@unc.edu

FEDERAL CHILD WELFARE POLICY AND FAMILY FIRST 69

child placement services and foster care maintenance payments is a much-needed

improvement over prior funding constraints (Children’s Defense Fund 2018). At the

same time, there is growing concern among child welfare professionals and advocacy

groups that Family First’s focus on clinical interventions that are targeted at families

of children who are at immanent risk of removal because of reported maltreatment

is too limiting. Given the role that poverty plays in child welfare, the lack of recogni-

tion of poverty as an impediment to family stability in the law and its failure to allow

for basic supports to help prevent or ameliorate poverty related challenges and

address selective needs for income support and concrete services may hamper the

efficacy of clinical interventions (see Slack and Berger, this volume; Feely etal., this

volume). The fact that very few of the interventions rated as evidence supported by

the Title IV-E Prevention Services Clearinghouse (Clearinghouse) have been dem-

onstrated to be effective with minority populations, especially Black and American

Indian/Native Alaska (AI/NA) populations that are overrepresented in the child wel-

fare system, also warrants careful consideration. That there is so little current evi-

dence for which services work specifically with Black and AI/NA populations may

prevent the law from achieving its stated purpose and contribute to the presence or

growth of racial disparity by failing to offer Black and AI/NA families equal access to

prevention services. Relying on existing evidence-supported interventions without

adequately testing their generalizability to minority populations may actually end up

perpetuating racial disparities (for a discussion of racial disparities in the child welfare

system, see Dettlaff and Boyd, this volume).

Other unintended consequences include a possible disincentive for child wel-

fare agencies to fund community-based, primary prevention services and sup-

ports, which can help to strengthen parental protective capacities prior to severe

need or instability, in favor of selective mental health services and substance use

treatment rated as reimbursable by the Clearinghouse.

In this respect, Family First could discourage upstream efforts to prevent

deeper-end needs from developing. Mindful of Family First’s potential risks and

benefits, this article considers how child welfare agencies can best leverage the

opportunities presented by the law to address potential barriers posed by the

paucity of evidence-supported, universal prevention programs and avoid the

unintended consequences of limiting reimbursement to only selective prevention

services that meet evidence standards.

Universal, Selective, and Indicated Prevention Programs

Family First became operative on October 1, 2019. The new law rededicates

Title IV of the Social Security Act to its original purpose of maintaining children

David Kelly is special assistant to the associate commissioner of the Children’s Bureau (CB).

He has overseen CB’s work with courts and the legal community and advised CB and ACF

leadership for more than a decade. He has served as an attorney representing parents and

youth in child welfare proceedings, as senior assistant child advocate for the State of New

Jersey, and in leadership positions with child and family advocacy organizations.