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A Closer Look at Family First — The Pros and Cons of Recent Foster Care Legislation
By Lindsey Getz

More than 400,000 children in the United States live in foster care, and that number is continuing to rise, driven by societal pressures including the opioid crisis. Those working in child welfare know that preventive measures to keep kids safe at home have received insufficient attention or funding over the years. But the Family First Prevention Services Act, signed into law by President Trump on February 9, 2018, has been touted as just that.

Family First is said to include long-overdue reforms to help keep children with their families and to avoid entering foster care in the first place by putting funds toward at-home parenting classes, mental health counseling, and substance use disorders treatment. As with any new legislation, it seems to have produced mixed reactions. While some say that Family First is a major step in the right direction, others have some concerns weighing on their minds. Overall, the legislation has everyone interested to see how the details will play out.

Baby Steps Toward Change
Family First restructures how the federal government spends child welfare dollars—and that is restructuring that many say should have happened a long time ago.

“The biggest win here is that some federal money will now be available earlier in the child protection/well-being process such that dollars can be spent on critical services to prevent foster care, including evidence-based substance abuse treatment, in-home parenting skill building, and mental health treatment,” says Johanna K.P. Greeson, PhD, MSS, MLSP, an associate professor and codirector of Child Well-Being & Child Welfare Specialization in the School of Social Policy & Practice at the University of Pennsylvania. “The goal is to support the needs of families of children, who, without such services, would likely require out-of-home placement.”

Greeson calls it a “first step” toward change, acknowledging that change can be time consuming and is often achieved in baby steps.

While one would be hard-pressed to find an opponent to legislation that aims to focus on prevention, some say that Family First isn’t as focused on prevention as they’d hope.

“At its core, I think it’s a good concept,” says Angie Schwartz, Esq., policy director for Alliance for Children’s Rights, an organization focused on protecting the rights of impoverished and abused children and youth. “No one would argue that investing in prevention isn’t a great thing—as this policy claims to do. But the devil is in the details in terms of how that will translate into real child welfare practice. That’s because when we talk about prevention, we hope that means preventing child abuse and neglect from happening in the first place—and that’s not what Family First does.”

Schwartz says the problem is that Family First funds kick in only once significant abuse and neglect have already occurred. The policy language states that the children must be deemed “foster care candidates” in order to be eligible for the funds. At this point, Schwartz says, there has already been a substantiation of abuse and neglect. This is more than just semantics, Schwartz says. It puts child welfare on a treacherous path if prevention is so loosely defined.

“I think this puts us in dangerous territory in terms of what defines prevention,” Schwartz says. “Family First defines prevention to include children who cannot be kept safely at home and who are moved into a relative’s home. In these cases, the removal itself has clearly not been prevented. What’s prevented is the child welfare agency taking responsibility for that placement, even though they facilitated the removal. I think the language is very misleading—even dangerous—if prevention is what they are emphasizing.”

Sean Hughes, a California-based child welfare consultant and former Democratic congressional staffer, agrees.

“Since the abuse and neglect have already occurred in order for a child to be eligible for funds, at best, you can call this early intervention—or perhaps family preservation,” Hughes says.

What About Caregivers?
Another big concern for advocates Hughes and Schwartz is that Family First will heavily burden extended family members who, as “kinship caregivers,” presumably won’t be eligible for foster care payments if caring for children under this new law. If this is the case, Hughes says that Family First closes the door to a lot of safety nets that have been developed for kids in foster care.

“Foster care entry has always been the front door to very important services and programs,” Hughes says. “This law calls for children to be moved into relatives’ homes—which is always the goal. But when you do that by going through the foster care system, and you license the relative as a foster parent, then the child and relative foster parent receive all resources and supportive services. They have a caseworker to support the placement and many services that they really rely on help them care for a child that has unexpectedly been placed with them. However, Family First envisions placing children with relatives informally—outside of the court process—which in turn will deprive them of those critical support services and programs.”

“I think this is something that social workers would want to be keenly aware of as they’re a key part of the support system for caregivers,” Hughes adds. “We must ask ourselves, does placing a child outside of the formal foster care system make sense if it means depriving them of support? I think most would say no.”

Hughes says that it really comes down to this idea that “foster care is the problem,” which he says is the approach that Family First takes. But Hughes says that he would argue “that child maltreatment is the problem, while foster care is an imperfect solution designed to support the child and the caregiver through a difficult period.”

“I don’t believe that keeping kids that have experienced significant maltreatment out of the foster care system is doing them any good if we look at the system as a safety net that has been constructed to support them, especially in instances when they can be placed with caring relatives who are licensed as foster parents,” Hughes says.

While Greeson says that she agrees that foster care has powerful supports built in, she says that there are key changes that are needed and it’s important to remember the incremental nature in which significant change is achieved.

“There is an old adage about babies floating down a river and social workers furiously trying to rescue them all,” Greeson says. “The real question is further up stream and trying to figure out how to prevent the babies from being thrown into the river to begin with. Although Family First does not move us all the way upstream in terms of prevention, it does give us more ways to intervene midstream.”

Additional Considerations
Another concern for those questioning Family First is the timeline. The Family First funding directed toward prevention is focused toward three types of services—mental health, substance use disorders treatment, and in-home parenting training programs. States will be able to use matching federal funding to provide “at-risk families” with up to 12 months of these services. Eligible beneficiaries are the families of children identified as safe staying at home, teen parents in foster care, and other parents who need preventive help, so their children don’t end up in the system.

But Hughes worries that 12 months of preventive care simply isn’t enough.

“I think it’s problematic that the prevention services are time-limited to 12 months,” he says. “What happens if Mom or Dad are not fully rehabilitated in 12 months, as is often the case with addiction? Will we just continue to leave these children in informal relative care without sufficient resources, services, and oversight?”

However, in terms of the timeline for foster care eligibility, Greeson says there are some key positives to be considered. Family First expands the eligible age from 21 to 23 years old for services authorized under the Foster Care Independence Act of 1999 for youth who will age out of foster care.

“Along the same lines, Family First extends eligibility for education and training vouchers, or ETVs, for youth who have aged out of foster care to age 26,” she says. “This is all good news, as the changes send the message that the process of becoming an adult is an extended one for all young people, including older youth and young adults in foster care, and they need the same time to take on adult roles and responsibilities in order for the transition to be safe, healthy, and productive. As brain science has revealed, the brain continues to develop throughout the 20s and, perhaps while not directly intended, Family First is acknowledging this fact.”

Another positive that Greeson sees for social workers is the fact that Family First limits federal funds for congregate care placements, unless a young person is in a qualified residential treatment program (QRTP), among other exceptions. Amid an array of components, a QRTP must use a trauma-informed treatment model.

“It’s always good news when our treatment approaches become trauma informed,” she says. “Young people in residential care typically have endured a laundry list of traumas and deserve treatment that acknowledges this reality and is prepared to support them in their recovery, instead of focusing solely on managing problem behaviors.”

An Important Conversation
Unquestionably, Family First has brought mixed feelings to light; however, it’s clear that everyone agrees more steps toward prevention are important. Moving forward, Schwartz says that she would advise states to be realistic about how to implement Family First in order to “be the most impactful and allow states to maximize the supports available to children and families.”

“I think there are still quite a few questions to be answered as we move forward with this,” Schwartz says. “There is an opportunity with Family First to be more creative in designing programs that allow children to remain safely at home—but when children cannot remain safely in the home of a parent, it’s critical that the policies are aimed at promoting and protecting that child’s best interest and keeping that child safe. At the end of the day, we absolutely must make sure we’re keeping kids safe.”

While there’s quite a bit that has Schwartz and Hughes worried about Family First, they say that it’s also a step toward having a more in-depth and realistic conversation about what true prevention is—and how to get to a place where primary prevention is supported in the future.

“There undoubtedly has not been enough focus on prevention—but when I say prevention, I mean prevention of abuse and neglect,” Schwartz says. “It’s so important that we’re having the same conversation. When I talk about prevention, I’m talking about the policies needed to keep kids safely at home. Right now, we’re headed in a dangerous direction of wanting to prevent foster care but being okay with a child’s removal outside of the system designed to protect them. In my opinion, we need to find better ways to support relatives through the foster care system—not outside of it.”

“I think going forward, we need to think about how we can leverage the opportunity that this law provides while being thoughtful and recognizing its shortcomings,” Hughes says. “I think it’s a step forward in the sense that there’s an attempt to be more focused on prevention, but I do think we need to be clear that where things stand right now, this is early intervention. We need more steps in the direction of true prevention.”

— Lindsey Getz is a Royersford, PA-based freelance writer.