In 2018, the Family First Prevention Services Act (Family First) became federal law. Family First contains an array of significant child welfare policy reforms. The two largest reforms are allowing states to use Title IV-E funds to support services to safely prevent the need for foster care, and new quality and appropriateness standards for non-family settings to promote family-based foster care placements whenever possible.
The goal of Family First is to apply downstream pressure at all junctures of child welfare involvement by placing fewer children in out-of-home care and by placing children who are in out-of-home care in a family-like setting rather than in congregate care, whenever possible. Family First’s requirements to drastically improve standards for congregate care placements (group homes, residential facilities, and other institutional settings) are critical to advancing that goal.
To achieve this goal, Family First created several categories of allowable non-family placement settings. According to the Administration for Children and Families (ACF) these settings include:
- A Qualified Residential Treatment Program (QRTP)
- A setting specializing in providing prenatal, post-partum, or parenting supports for pregnant or parenting young people
- In cases when the child is 18 years old, a supervised independent living setting; or
- A setting with high-quality residential care and support services for youth who have been found to be, or are at risk of becoming, sex trafficking survivors, defined by each state’s policies and procedures.
Family First created the model of QRTP to ensure residential treatment is appropriate, time-limited, and meets a child’s treatment needs. To access Title IV-E maintenance payments, Family First requires congregate care facilities to meet a certain standard of care and be accredited as a QRTP....
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