State Implementation of The Family First Prevention Services Act to Address Parental Substance Use

• In Event: When Policy Meets Practice: Policies that Influence the Child Welfare Trajectory

Abstract

Background: The Family First Prevention Services Act (FFPSA) of 2018 created new flexibilities for state child welfare systems to use federal funds to provide services to prevent parents from losing child custody. This included new opportunities for state child welfare agencies to pay for certain substance use related services that were deemed evidence-based by a clearinghouse operated by the Administration for Children and Families. Purpose: Little is known about how states are implementing FFPSA and what substance use services, if any are being provided. This study fills these research gaps by characterizing state implementation of substance use related FFPSA provisions.Research
Design and Methods: We conducted  semi-structured interviews with 47 individuals, 17 national experts and 30 state-level child welfare and health officials, across 16 states. Interview domains included: 1) current provision of SUD-related services under FFPSA, 2) FFPSA implementation strategies, and 3) implementation facilitators and barriers. A hybrid inductive/deductive coding approach was used to conduct thematic analysis.Results/Findings: Interviewees perceived that while FFPSA was intended to drastically overhaul child welfare agencies’ response to parental drug use and prevent family separation, implementation has hindered states’ ability to achieve these goals. States vary widely in usage of FFPSA funds for substance use related services, with very few offering parental treatment services. This is in part due to challenges coordinating between child welfare and the treatment service system. Another key barrier is the clearinghouse of federally approved evidence-based services that states must choose from. The services in this clearinghouse have not included gold standard treatment services, de-emphasize evidence related to health impacts on parents, and offer limited options and opportunities to fund high-functioning state specific programs. Conclusions/Implications: FFPSA offers a new mechanism to provide substance use services for parents in the child welfare system. However implementation improvements are needed, including updating federal guidance to states, supporting coordination between state child welfare and health agencies, and better incorporating health evidence into the child welfare system. Improving this mechanism for funding services may be particularly important as states face broader cuts to treatment and support services.

Author

• Sachini Bandara, Johns Hopkins University
  Presenting Author