Policy Hopes and Practice Realities: Understanding the Failed Promise of the Family First Prevention Services Act

• In Event: Upstream Policies, Downstream Harm: Systemic Influences on Child Welfare

Abstract

Background: The Family First Prevention Services Act (FFPSA) was signed into law in 2018 with the goal of shifting child welfare towards preventing out of home placement. Stakeholders across the spectrum of child welfare advocacy and service provision hailed the policy as a transformational opportunity, as states would be allowed to use Title IV-E funding for prevention services for the first time, as long as they selected from a list of pre-approved evidence-based practices (EBPs). However, by the end of 2023, states had filed few claims for Title IV-E reimbursement under this policy, meaning that this highly desired policy had little take-up on the ground. In the present study, we shed light on why this gap between policy expectations and practice realities may have emerged by asking:  How did child welfare stakeholders understand and experience FFPSA policy requirements and their fit with  local practice conditions? 

Methods: We studied potential policy-practice gaps through a qualitative study of the FFPSA implementation process in the state of Minnesota. Data was collected from April 2020, when planning began, to January of 2022, when the draft state plan was complete.  Our analysis is based on 40 semi-structured interviews with key stakeholders involved in the planning process, including state and county administrators, nonprofit providers, advocates, and representatives of tribal organizations as well as 100 hours of participant observation in workgroup meetings where elements of the FFPSA implementation plan were proposed, discussed, and decided on. We utilized inductive coding and general thematic analysis of these interviews and observations.

Results: Participants identified three main policy-practice gaps that contributed to the anemic implementation of this policy.  First, they perceived the requirement that only  EBPs listed on an evidence Clearinghouse could be used for reimbursement as limiting professional autonomy and responsiveness to families’ needs. They believed the policy forced providers to try to “fit” families into one of the EBPs selected from the Clearinghouse instead of tailoring services to families’ specific needs and culture. Second, while providers hoped for a primary prevention model that would serve families prior to formal system involvement, FFPSA’s definition of candidacy did not allow that. Practitioners  felt that negative experiences with child welfare would be a barrier to prevention services uptake and exposing more families to the formal system was not appropriate. Third, respondents identified existing system capacity problems that would strongly limit the ability of child welfare agencies to provide identified EBPs: workforce shortages, limited training dollars, and unavailability of services in rural areas. 

Discussion: Taken together, these findings show how FFPSA’s failure to be robustly implemented may be related to a mismatch between social work practice realities and the demands of evidence based policy. Policy implications include the need for designing policy with  flexibility for local conditions and proactive responsiveness to diverse family needs. Increasing access to prevention services may involve addressing the root causes of the limited system capacites, like workforce shortages. 

Author

• Bethany J. Elston, The University of Chicago
  Presenting Author