PowerPlusWaterMarkObject357831064 Shared By Senate Finance Committee Staff The Family

powerpluswatermarkobject357831064 *shared by senate finance committee staff* the family first act: section by section title i – keeping

PowerPlusWaterMarkObject357831064
*Shared by Senate Finance Committee Staff*
The Family First Act: Section by Section
Title I – KEEPING CHILDREN SAFE AND SUPPORTED AT HOME OR IN THE MOST
FAMILY LIKE SETTING
Subtitle A. Investing in Prevention and Family Services
Section 101. Findings
Section 102. Purpose
Part I – Prevention and Family Services and Programs under Title IV-E
Section 111. Assistance for children who are candidates for care
Amends Section 471 (State Plan) to create new subsection “e”
PREVENTION AND FAMILY SERVICES AND PROGRAMS
Allows states and tribes to provide specific services to children,
parents and kin caregivers for 12 months. In order to be eligible, the
child or youth involved must be a “candidate” for foster care or a
pregnant or parenting youth in foster care. A candidate is a child
identified by the state agency in a prevention plan as at imminent
risk of entering (or re-entering) foster care and who it determines
can remain safely at home or in a kin placement (outside of foster
care) as long as Title IV-E services or assistance are provided.
Services are – mental health, substance abuse prevention and in-home
parent skill-based programs (including parent training and individual
and family counseling).
The state is required to maintain a prevention plan for the candidate
child that lists the services or assistance and identifies the
permanency goal for the child. Services must be tied to the placement
and permanency goal; they must be specified in advance of provision
and must be trauma-informed.
Allows states to draw down FFP for a specific service array
(short-term financial support and kinship navigator services) for kin
caregivers who assume responsibility for relative children who cannot
be cared for by their birth parents. Kinship placement policy has a
dual purpose – first to provide temporary assistance for kin when
relative care is the permanency option for the candidate child and
second to provide support for a temporary placement with kin when
reunification is the permanency option for the candidate child.
Federal IV-E support is available for these services and assistance
beginning FY2018 if the state opts to amend its Title IV- E plan to
include these IV-E services and meets specific requirements related to
their provision. Federal financial participation (FFP) for short-term
financial support and for kinship navigator services is set at a
state’s regular FMAP. Access to these kin supports, however, is phased
in based on a child’s age. The phase in begins October 1, 2017 with
children age 16 and older (up to state’s maximum age for Title IV-E
assistance) eligible for this assistance. That eligibility age will
decrease by two years each fiscal year so that, as of October 1, 2025,
kin of candidates for care of any age will be eligible.
For other services or activities (mental health, substance abuse
prevention and in-home skilled-based programs) the services for
candidates for care and their parents or kin caregivers must be
evidenced-based. Full FFP is phased in and the evidenced based
standard is increased over time, as follows:
*
Beginning 10/1/2017– FFP is 40% and services may be promising,
supported or well supported
*
Beginning 10/1/2020– FFP is 50% and services must be supported or
well supported
*
Beginning 10/1/2023– FFP is the state or Tribe’s FMAP and services
must be well supported
Mark also provides, as of 10/1/2017, a 50% match for training and all
other costs of administering the services component of this plan. FFP
under this component would not be subject to any “look-back” related
rules.
Establishes three categories of evidence-based policy: Promising
Practices, Supported Practices, and Well-Supported Practices
a.
Promising Practice Criteria –
1.
There is no case data suggesting a risk of harm that: a) was
probably caused by the treatment and b) the harm was severe or
frequent.
2.
There is no legal or empirical basis suggesting that, compared
to its likely benefits, the practice constitutes a risk of harm
to those receiving it.
3.
The practice has a book, manual, and/or other available writings
that specify the components of the practice protocol and
describe how to administer it.
4.
At least one study utilizing some form of control (e.g.,
untreated group, placebo group, matched wait list study) has
established the practice's benefit over the control, or found it
to be comparable to a practice rated a 1, 2, or 3 on this rating
scale or superior to an appropriate comparison practice. The
study has been reported in published, peer-reviewed literature.
5.
Outcome measures must be reliable and valid, and administered
consistently and accurately across all subjects.
6.
If multiple outcome studies have been conducted, the overall
weight of evidence supports the benefit of the practice.
b.
Supported Practice Criteria – Must adhere to 1-3 and 5, 6 of
Promising Practice criteria. In addition the practice must satisfy
the following criteria:
*
At least one rigorous randomized controlled trial (RCT) OR a
control or comparison group with pre and post outcome assessments
in usual care or a practice setting has found the practice to be
superior to an appropriate comparison practice.
*
In that same RCT or comparison study, the practice has shown to
have a sustained effect of at least six months beyond the end of
treatment, when compared to a control group.
The trial or outcomes of the control or comparison group must be
published in peer-reviewed literature.
c.
Well Supported – Must adhere to 1-3 and 5, 6 of Promising Practice
criteria. In addition the practice must satisfy the following
criteria:
*
At least two rigorous randomized controlled trials (RCTs) OR
control or comparison groups with pre and post outcome assessments
in different usual care or practice settings —
*
have found the practice to be superior to an appropriate
comparison practice;
*
have been reported in published, peer-reviewed literature; and
*
in at least one of these RCTs or control or comparison group
the practice has shown to have a sustained effect of at least
one year beyond the end of treatment, when compared to a
control group.
Requires the Secretary to issue guidance to states including a list of
services and programs that meet the evidence-based policy standards.
The state is required to collect and report data to the Secretary on
services and assistance provided with Title IV-E funds, including
numbers of children served, costs of those services, and information
about whether or not the child remained out of foster care during the
12-month services period (and the 12 subsequent months). HHS will
provide guidance and develop national performance measures.
MOE – States must continue to spend the same amount of state and local
dollars on foster care prevention services as they did in FY2014. That
amount of money is considered the state’s MOE and none of those
dollars may be used to draw down new IV-E funding. HHS is to define
foster care prevention services but in the calculation, HHS must
include all state and local expenditures for those purposes that were
spent in FY2014 under IV-B, TANF or SSBG.
Requires the Secretary to provide technical assistance to States
regarding the provision of services and conduct research, collect data
and provide evaluations to identify promising programs and assess the
extent to which the programs and services provided reduce foster care
placements, increase kinship arrangements, and improve child
well-being.
Section 112. Foster care maintenance payments for children with
parents in a licensed residential family based treatment facility for
substance abuse.
States may draw down IV-E foster care maintenance payments on behalf
of children who are placed in residential family treatment settings
with a parent who is receiving treatment.
Part II – Enhanced Support Under IV-B
Section 121. Short-term crisis intervention assistance in order to
stabilize a family in times of crisis or to facilitate a kinship
placement.
Creates a capped mandatory funding allotment for short-term crisis
assistance. Amount TBD (Placeholder)
Section 122. Elimination of time limit for family reunification
services while in foster care and permitting time limited family
reunification services when a child returns home from foster care.
Renames the category of services within the Promoting Safe and Stable
Families (PSSF) program known as “time-limited family reunification
services” as “family reunification services”. Removes the current law
limit which says services under this category may only be offered to
or on behalf of children who have entered foster care within the last
15 months. Permits these services for any child in foster care and
allows them to be provided for up to 15 months after a child is
reunited with the biological family. Often children are most in need
of services when they reunify with their birth family so this allows
flexibility in providing such services. (This is a definition change
only; does not increase funding available)
Part III – Misc.
Section 131. Establishment of national model licensing standards for
placement in a relative foster family home
Requires the Secretary, by regulation, to establish national model
foster care licensing standards for relative caregivers and requires
states to explain why they deviate from such standards, if applicable.
Section 132. Modernizing the title and purpose of title IV-E
Sec 133. Effective date
Sets effective date of October 1, 2016.
Application to tribes – Any tribe operating a Title IV-E plan may also
access this Title IV-E funding for prevention services, programs and
assistance, provided that it generally met the same requirements as
those applicable to states.
Subtitle B – Ensuring the Necessity of a Placement that is not a
foster family home
Section 141. Amends Section 472 (Foster Care Maintenance Payments) to
place limitation on Federal Financial Participation for placements
that are not in foster family homes.
After 2 weeks, FFP for placements other than a family foster home
(defined) available only for the following: a Qualified Residential
Treatment Program or QRTP (defined), a facility for pregnant and
parenting teens, or an independent living arrangement.
Requires an assessment to be completed 30 days after placement in a
QRTP (detailed in Section 142); if a QRTP is not the appropriate
placement the step up or down must be completed within an additional
30 days and allows FFP during this transition period.
QRTP defined –
*
Clinically-recognized treatment model, able to implement treatment
identified by the assessment; licensed staff, facilitates
participation with family, documents how family members are
integrated, provides discharge planning and aftercare support for
at least 6 months, licensed and accredited.
Foster family home defined –
*
Licensed and approved by the state as a family foster home, with
no more than 6 children in foster care. Exceptions can be made
for: a parenting youth in foster care, siblings, meaningful
relationship, and child with a severe disability.
Conditions receipt of court improvement program funding on the
provision of training for judges about federal policies on placement
of foster children in non-family settings. Requires states to assure
that state is not shifting children from congregate care settings to
the juvenile justice system as a consequence of this policy and
requires GAO to issue a report to Congress related to the impact of
this policy on the juvenile justice system.
Section 142. Assessment and documentation of the need for placement in
a qualified residential treatment program.
Requires that within 30 days of the start of each new placement of a
child in a QRTP a qualified individual must make an assessment, using
a validated and evidence-based assessment tool, and determine whether
or not the child’s needs can be met with family members or in a family
foster home and if not, which of the approved foster care placement
settings would provide a more effective and appropriate level of care.
This assessment must be done in conjunction with a family and
permanency team assembled by the state. This team is comprised of
relatives, fictive kin, professionals, teachers, clergy, etc. State
shall document efforts to form family team and meet with and engage
with the family team.
Within 60 days of a placement in a QRTP, a court must review the
assessment and approve or disapprove the placement. State is required
at each status review and permanency hearing for a child in a QRTP to
demonstrate why the child cannot be served in a family foster home,
why the placement in the QRTP continues to be necessary and consistent
with the child’s short and long-term goals, document efforts to step
the child down into a more family-like setting, and other
requirements.
After 6 months for a child under the age of 13 and after 12 months
consecutive/18 month non-consecutive for others, the state agency must
submit documentation to the Secretary and notify the parents, kinship
caregiver, legal guardian or any counsel on record that the child has
a private right of action to the least restrictive environment.
Section 143. Protocols to prevent inappropriate diagnosis
Requires state child welfare plans to include the procedures and
protocols to ensure children in foster care are not inappropriately
diagnosed with mental illness or other disorders or conditions and
placed in non-family based settings as a result of such diagnoses.
Section 144. Compliance audits and evaluations
Section 145. Additional data and reports regarding children placed in
a setting that is not a family foster home
Updates reporting related to placement options for children in foster
care to ensure such data includes whether the placement setting for a
child is: shelter care, a group home, residential treatment, a
hospital, a setting for pregnant or parenting youth, other type of
child care institution; and, the number of children in such setting,
the length of placement, the previous placement, whether the child has
special needs, etc.
Section 146. Effective date, application to waivers
Generally provisions that directly affect Title IV-E
claiming/eligibility relative to congregate care policy are not
effective before October 1, 2019.
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