A National Perspective on the Family First Prevention Services Act (FFSPA)

Innovative Conversations Session 6 – Recorded September 2019

Guest Sheila Pires, Managing Partner, Human Service Collaborative​ Core Partner, National TA Network for Children’s Behavioral Health​, speaks with former CIP Director and Innovative Conversations host, Patrick Kanary present a national perspective discussing the Family First Prevention Services Act (FFSPA). It is the first installment of a two-part discussion, the second of which will explore Family First from a state-wide perspective in Ohio with Ohio specialists Carla Carpenter, Angela Sausser and Crystal Ward Allen. To listen to FFSPA Part 2, click here.

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The Center for Innovative Practices (CIP), part of the Begun Center for Violence Prevention at the Mandel School of Applied Social Sciences at Case Western Reserve University, has developed a podcast initiative entitled, Innovative Conversations, exploring topics pertaining to the CIP mission of identifying promising practices and evidence-based interventions for youth dealing with mental health, substance use, trauma, and judicial justice challenges. Hosted by first CIP director Patrick Kanary, the series also examines how Wraparound Systems of Care can better facilitate how integrated treatment can help yield optimal outcomes with youth recovery.

View Innovative Conversation Webinar Session on Family First | View FFPSA Powerpoint Presentation

This session involves the Family First Prevention Services Act (FFPSA) and what it means to states funding in-home treatment and recovery for at-risk you dealing with the challenges of mental health, substance use, trauma, and judicial justice issues.

The Family First Prevention Services Act was signed into law as part of the Bipartisan Budget Act on February 9, 2018. This act reforms the federal child welfare financing streams, Title IV-E and Title IV-B of the Social Security Act, to provide services to families who are at risk of entering the child welfare system.

The bill aims to prevent children from entering foster care by allowing federal reimbursement for mental health services, substance use treatment, and in-home parenting skill training to families and children. It also seeks to improve the well-being of children already in foster care by incentivizing states to reduce placement of children in group care.

In her presentation and ensuing discussion with Patrick Kanary, Sheila Pires identifies two major related goals:​ Funding for prevention services​ and the Limits on use of congregate care​. Prevention Services​ Allows use of Title IV-E for Prevention Services and Supports (i.e., to prevent placement of children and youth into foster care and placement disruption for children/youth in adoptive or kinship guardian homes)​.

In addition, IV-E reimbursement allowed for up to 12 months for a child placed with a parent in a licensed residential family-based treatment facility for substance abuse, regardless of whether child meets AFDC income eligibility, which became effective Oct 2018​.

Prevention Services Eligibility​
Populations eligible to receive services include: 1) Parents or relatives caring for children/youth who are “candidates for foster care” – at imminent risk of entering foster care but can remain safely at home with services and supports 2) Adoptive parents and relative guardians where placement disruption is issue ​3) Youth in foster care who are pregnant or already parents and​ 4) Eligible children, youth, parents and kinship caregivers are eligible for services regardless of whether they meet the AFDC income eligibility requirements for IV-E reimbursement​.

Extending to age 23, this  supports the youth population transitioning out of foster care. It also extends to age 26 the eligibility for education and training vouchers (Chafee Foster Care Independence Program)​.

Prevention Services
​Prevention services and supports must be promising practice, supported practice, or well-supported practices, with 50% of expenditures for prevention services being  for well-supported practice​s.

Funds also can be used for training and administration related to the provision of prevention services and supports, including data collection and reporting​

Federal Match​
Between October 1, 2019 and Oct 1 2026, there is a 50% Federal IV-E match for prevention services. Beginning Sept 30 2026, Federal IV-E match for prevention services will be the same as the state’s Federal Medicaid match rate ​

Maintenance of Effort
States cannot spend less than they did in FY 2014 on prevention services, i.e., cannot substitute FFPSA dollars for state and local prevention expenditures ​

Sheila A. Pires is a founding partner of the Human Service Collaborative of Washington, D.C., a policy and technical assistance group specializing in child and family service systems. Ms. Pires has over 35 years of experience in national, state, and local government and non-profit agencies serving children, youth and families at risk.

She has held senior staff and management positions in the U.S. House of Representatives, the U.S. Department of Health, Education and Welfare and the Carter White House. She co-chaired the children’s mental health and substance abuse committee of President Clinton’s Task Force on Health Care Reform and co-authored the children’s issue brief and policy recommendations for President Bush’s New Freedom Mental Health Commission.

In the Obama Administration, she was invited to present on children’s behavioral health at the Center for Medicare and Medicaid Services Grand Rounds. She serves as the Senior Consultant to the Children in Managed Care and Child Health Quality Programs at the Center for Health Care Strategies and is a core partner of the National Technical Assistance Network for Children’s Behavioral Health, co-leading the Network’s work on policy, system design and financing.

Ms. Pires served as Deputy Commissioner of Social Services for the District of Columbia and led a reorganization of the city’s child mental health system as head of child mental health services. She has consulted with most states, as well as counties, cities, neighborhoods, foundations, and family-run organizations, and has authored numerous publications on systems change, including Building Systems of Care: A Primer.

She has served on the National Board of the Federation of Families for Children’s Mental Health and currently is on the National Advisory Council of the Hogg Foundation for Mental Health. Ms. Pires received her B.A. from Boston University and a Master of Public Administration from Harvard University.

Additional Resources

Family First Prevention Services Act (P.L. 115-123)


Family First Advocacy Toolkit | American Academy of Pediatrics

National Conference of State Legislatures

Information Memorandum on Family First (IM-18-02)​

Program Instruction – Implementation of Title IV-E Plan Requirement​

Child Welfare Community Letter – October 1, 2018​

Program Instruction – State Title IV-E Prevention and Family Services and Programs​

Program Instruction – Tribal Title IV-E Agency Requirements for Electing Title IV-E Prevention and Family Services and Programs​

State Child Welfare Director Letter – January 2, 2019​


Family First Advocacy Toolkit | American Academy of Pediatrics


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