Family First: Keeping Children At High-risk Safe In The District Of Columbia And Nationally

Rachel Molly Joseph, MSW, JD 

Chief of Staff

Child and Family Services Agency

As early childhood systems builders, we are well aware that infants and young children undergo rapid developmental changes that are highly influenced by relationships and environment. Supporting families to provide safe, stable, nurturing relationships and environments should be a key element of early care and education programs and services, particularly those that serve populations at high-risk, such as children at risk of entering foster care. (National data show that children birth to age five are at higher risk of placement and enter foster care at higher rates than older children and youth.) Programs and services also should be provided to help prevent child abuse and neglect and to aid pregnant women and families with young children. Through recently approved federal legislation, protecting children at high-risk has become more actionable.

New Federal Investment in Keeping Children Safe 

The federal government, recognizing that prevention services can have a powerful impact on well-being outcomes, recently stepped up its efforts to support families and children at high-risk. The Family First Prevention Services Act of 2017 (Family First) was passed as part of the Bipartisan Budget Act of 2018 and signed into law on February 9, 2018. The landmark legislation allows states to invest in prevention and family services to help keep children safe and supported at home. Family First is an unprecedented opportunity to scale evidence-based practices to prevent child abuse and neglect and entry into foster care. The act provides federal funds, beginning in FFY2020, to support evidence-based mental health and substance abuse prevention and treatment services, as well as skill-based services parenting programs. Services are designed to meet the needs of children who are deemed at imminent risk of entering foster care. Services must be trauma-informed and provided to these children, their parents, and/or caregivers. Family First also provides funds for these services to pregnant or parenting teens and their children. Family First services must adhere to evidence criteria established in the legislation; that is, services must be “promising, supported, or well-supported” as designated by a newly created federally approved clearinghouse. In addition, children and their families receiving prevention services must have a child-specific prevention plan describing the service to be received and its use to prevent entry into foster care.

Clearinghouse of Rated Programs 

As of August 2019, 12 programs have been rated by the Family First Prevention Services Clearinghouse. Of the 12 programs rated, nine have been designated “promising, supported, or well-supported.” Of these nine, three programs, Nurse-Family Partnership (NFP), Parent-Child Interaction Therapy (PCIT), and Parents as Teachers (PAT), specifically target children from birth to five years of age.

Putting Families First in the District of Columbia 

In the District of Columbia, as of August 2019, 26 percent of children in foster care are under five years old, and, over the last two years, between 44-46 percent of the children entering foster care have been ages 0-5. For the past decade, the District of Columbia’s Child and Family Services Agency (CFSA) has been on a transformational journey, moving purposefully away from a system primarily focused on placing children in foster care to one that supports and strengthens families and serves them in their own homes. The enactment of Family First provides a new opportunity to expand our efforts and implement a holistic prevention strategy. Our aim is not to be driven by Family First, but rather to leverage new opportunities provided by Family First as part of a comprehensive approach to family and child well-being.

In April 2019, after an extensive stakeholder engagement process which included members of the Statewide Early Childhood Development and Coordinating Council, we submitted Putting Families First in DC, the District of Columbia’s five-year prevention plan, to the federal Children’s Bureau. To develop this holistic plan, CFSA and our partners jointly reviewed data to select target populations for Family First prevention services that had: (1) high rates of foster care entry or re-entry in the past; and (2) high levels of risk according to a validated risk assessment tool. Where available, additional research evidence and data were examined to inform a deeper understanding of the risk of foster-care entry.

The District of Columbia’s Plan Details 

Within Putting Families First in DC, the District of Columbia identified 15 evidence-based programs that will be offered to target populations in an effort to prevent child abuse and neglect and entry (or re-entry) into foster care. Almost fifty percent of the programs selected target families with young children, including the following programs expanding the District of Columbia’s early childhood systems approach and strategies: Parents as Teachers, Nurturing Parenting Program, Healthy Families America, Chicago Parenting Program, Effective Black Parenting Program, Project Connect, Trauma-Focused Cognitive Behavioral Therapy, and Parent-Child Interaction Therapy.

In addition to scaling up evidence-based prevention programs targeting young children, the creation of child-specific prevention plans will be used in the District of Columbia to collaborate across child welfare and early childhood systems to track family needs and participation in programs, connect families to high-quality programs, and coordinate services across programs.

The data used to create Putting Families First in DC and the data collected from its implementation are being used in the District of Columbia’s Preschool Development Grant needs-assessment and planning process.

Include Early Childhood Experts in Family First 

Planning In the District of Columbia, we have used the Family First opportunity to leverage our early childhood system successes to bring prevention services to families with the youngest children. We believe that this approach will have positive long-term outcomes for family and child well-being. We know that states are currently engaged in prevention plan development and negotiations with the federal Children’s Bureau regarding their prevention approach. Given the correlation between high-quality early childhood programs and child abuse and neglect prevention, we feel strongly that early childhood professionals should be at the table.