Keeping Families Together: Can the Family First Prevention Act Deliver More?

On May 22, the U.S. Senate Finance Committee held a hearing on the Family First Prevention Services Act to elevate “successes, roadblocks, and opportunities for improvement.” One theme of the hearing related to the importance of economic and concrete supports to prevent abuse and neglect and strengthen families.

Committee Chairman Senator Wyden opened the hearing by stating: “Next up I’ll touch on prevention. Sometimes, in order to prevent the need for foster care, mom and dad might need a little help. Maybe a parent needs mental health care or substance use disorder treatment, or parenting training and support, or maybe the family needs to do family therapy. Or maybe parents just need help meeting the family’s basic needs. So under Family First, we created new federal funding for those services.”

In their submitted statements, numerous others called on the Committee to revise Family First to clarify the inclusion of economic and concrete supports. JooYeun Chang of the Doris Duke Foundation indicated, “[We recommend that Congress] expand the scope of elegible prevention services to include services and support to address interpersonal violence, system navigation and care coordination, and material and concrete support for families.” Child welfare leaders also report that inability to meet economic needs is often a contributing reason for family involvement with child welfare.

Over 40 years of evidence supports including economic and concrete supports as a core prevention strategy. Economic and concrete supports could be considered a stand-alone evidence-based service, or used to enhance the uptake, retention, and completion of evidence-based practices designed to address mental health, substance use or parenting challenges. And, states across the country are using economic and concrete supports in their prevention services array to good effect.

The Chapin Hall Meeting Family Needs: A Multi-system Policy Framework for Child and Family Well-being describes the continuum of economic and concrete supports families need to buffer economic shocks, like layoffs, and ensure basic needs are met so that risk of involvement with child welfare is decreased. This includes macro-economic policies like the child tax credit, child care, and paid family leave; expansion and increased accessibility of public benefits like Medicaid and Supplemental Nutrition Assistance Program; and the inclusion of flexible funds and cash when child welfare is involved.

The Doris Duke Foundation’s Opportunities for Prevention & Transformation Initiative (OPT-In for Families) seeks to test four strategies, including the use of economic and concrete supports to meet the material needs of families, navigation to services and benefits, engagement by community-based organizations, and access to supports at an early signal of need. This effort is testing these four strategies based on early family support and prevention efforts already underway to better resource families, prevent maltreatment from occurring, and reduce the nation’s unnecessary over-reliance on child protective services to meet family needs.

There is a wide-spread recognition that in addition to improving the life course of millions of children, there are important considerations regarding costs and return on investment when making policy. The lifetime costs associated with investigated cases of child abuse and neglect for the 2018 cohort is estimated at costing $2.94 trillion, while long-term cost savings due to reduced maltreatment-related costs from each additional $1000 spent on public benefit programs per person living below the federal poverty line is estimated at $153 billion. One study estimated that $1000 in an unconditional cash payments to families in the early months of a child’s life is estimated to reduce the likelihood of child protective services referrals and substantiations, as well as child fatalities.

To better meet families’ needs through the use of upstream prevention and economic and concrete supports, like what is being undertaken in OPT-In and in many other states implementing Community Pathways, federal policy can be refined to incorporate what has been learned over the last six years regarding successes, roadblocks, and opportunities for improvement. In addition to including economic and concrete supports as a specific category of evidence-based prevention services there is a need to reduce eligibility and other barriers for at-risk families to receive prevention services. For example, as JooYeun Chang commented in her invited testimony:

“The current statute defines eligibility for an individual child who is a candidate for foster care, at imminent risk of foster care entry,” and “if not for this service the plan for the child is foster care…This discourages families from taking advantage of the very prevention programs that Congress has made available through Family First...”

These terms anchor child welfare prevention in a coercion framework when new evidence and innovation point toward proactively engaging and supporting families upstream. This misalignment is holding back implementation of Family First, creates unnecessary administrative burden, and lacks coherence with authentically engaging families in prevention services that are voluntary and meet their needs.

The four OPT-In for Families jurisdictions and approximately 20 states developing Community Pathways to Family First services are innovating and helping to define a future where families get what they need, when they need it, so that challenges do not become crises and children remain with their families.

Clare Anderson is a Senior Policy Fellow at Chapin Hall and an advisor to the Doris Duke Foundation’s OPT-In for Families initiative.