A significant first step in the implementation of the Families First Act (read a CWLA description here) will come on October 1, 2018. Under the legislation the Department of Health and Human Services is directed to release the practice criteria required to define prevention services or programs. They are also directed to provide a pre-approved list of services and programs that meet the requirements of the three categories of services that states will be able to use when the services component of the law become effective two years later.

Two years from October 1, states will have an option to expand the use of Title IV-E funds for services to children and their families if that child or youth is considered at-risk of foster care placement. Services can cover mental health, substance use treatment and in-home services. Services funded can be for up to twelve months (services are not limited within a lifetime) but they must be for services that meet a promising, supported and well-supported standard as outlined in the law and further defined by HHS. The eligibility for the services will not be tied to the 1996 AFDC eligibility requirements and in the initial years matched at 50 percent before later being matched at the Medicaid matching rate (FMAP).

That is why October 1, 2018 could loom large.

Before a state acts they will have to have in place an approved plan by HHS that outlines certain specific provisions such as how the services covered will improve outcomes, how families will be assessed, how both the services will be monitored and how families and children will be monitored while receiving services and how the state will deal with a number of workforce issues such as training and caseloads.

Related to this is how the state will define children and youth at-risk of foster care. This expanded definition of candidates for foster care could include interventions—such as family preservation that attempts to prevent foster care placements but it could also be extended to the more than 50 percent of children and youth who exit foster care each year to reunification with their families. Additionally this definition could cover post adoption services to assist families that may be dealing with behavioral health issues years after an adoption has been finalized. The Families First Act also specifies that this funding can be used for youth in foster care who are parenting or expected to be parenting.

Beyond these basics are several other challenges states will have to address such as on-going research, data collection reporting and meeting the related maintenance-of-effort (MOE) i.e. requiring states to not use the new funds to supplant current spending in these areas, but the first steps will be coming in these opening months as HHS determines how the new law will be carried out when the new provisions kick in.