Evidence-based practice criteria's effect on the implementation of the Family First Prevention Services Act in Nebraska and Colorado

Abstract

Child abuse and neglect negatively affect more than 600,000 children annually in the U.S. As a result of that abuse, 4.68 children die each day. Most people assume that child abuse is physical or sexual, but those types comprise only 10% of cases. In contrast, child neglect is more than 60% of all reported child maltreatment cases. Child abuse, particularly neglect, is often preventable because many causes of harm stem from poverty, lack of social connections, substance use disorders, mental illness, lack of childcare, and other family support shortages. Prevention of child abuse and neglect starts with family support in these areas. In one statewide study of 13,067 families, increasing household income by an extra $105 to $180 per month for families in the intervention group resulted in a 10% decrease in child maltreatment reports. The federal government recognized this need for prevention, and through considerable bipartisan support, passed the Family First Prevention Services Act on February 9, 2018. It is the most significant child welfare reform in the past 40 years. The Family First Prevention Services Act was designed to divert funds away from long-term foster care and toward programs that prevent unnecessary placement and child protective services interventions. This child welfare system reformation is based on two fundamental principles related to child well-being. The first is the understanding that removing a child from an unsafe home does not guarantee their safety or well-being in another home. The second is that removing a child from their family can cause significant trauma. Longitudinal studies suggest that children on the margins of needing foster care placement do better when they stay at home with their families. Other studies reveal that 50% of children in foster care will not graduate high school, and 25% will experience PTSD comparable to that of a veteran. A recent longitudinal study has shown that children in out-of-home care had 1.5 times higher mortality rates between the ages of 20-56 than those who stayed home despite continued maltreatment. Many case studies show that children placed in foster care experience higher levels of abuse during their care than the general population. Although foster care is intended to be a last resort in child protection, the number of children in care is alarming. During the 2020 fiscal year, 632,000 U.S. children were in foster care at some point. As of September 30, 2020, 407,000 children were still in foster care, indicating that many more children entered care than went home. The lowest number of children in government custody since 2011 was 392,000 in 2011, and the highest was 437,000 in 2017. In addition to so many kids being in foster care, they are also there too long. The average length of care is 15.5 months. The Family First Prevention Services Act places restrictions on the state's use of federal funds for institutional foster care placements and uses that savings to fund reimbursements for evidence-based family preservation. The requirement for evidence-based prevention is a first in child-welfare federal law, and compliance with this requirement requires public-private partnership with agencies implementing the models, infrastructure, and evaluation standards that most states must build to be eligible for the new funding. This evaluation research analyzed how the stringent guidelines for prevention funding and the requirement of Federally approved evidence-based practice programming is affecting the implementation of the Family First Prevention Services Act in Nebraska and Colorado.--Author's abstract