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Can the Family First Act Fix the Foster Care System?

Can the Family First Act Fix the Foster Care System?

In early 2018, a significant piece of legislation titled the Family First Prevention Services Act (FFPSA) was signed into law at the federal level. Implementing FFPSA has been slow but has created a tremendous debate in the child welfare community. While this legislation has been largely celebrated, there seem to be just as many critical reviews of the legislation. Nationally, child welfare professionals are asked to manage caseloads that are too large and too diverse in complexity. The intensity of children’s needs and the trauma resulting from children moving in and out of foster care placements is fueling burnout of child welfare professionals. The intent of the FFPSA was to reduce the reliance on group care placements and increase the number of traditional foster homes.  

The Family First Prevention Services Act (Public Law 115-123) contains an array of provisions from addressing substance abuse to monitoring post adoption services. However, most experts agree the impetus for the bill was reducing the number of children living in congregate care settings such as group homes, treatment centers, and mental health facilities. There has long been a concern that group homes in the United States are elevated risk environments for further abuse and neglect of children in care. Experts have also expressed concern that these settings do not prepare children for future independence, nor do they help children in care develop critical relationships with caregivers. This has proven both true and false depending upon the providers of care. Certainly, some congregate care settings have been guilty of poor care, yet others have produced exceptional outcomes for children.

The United States child welfare system has long been both a necessary entity and a harrowing experience for children and families experiencing it. As professionals, we are aware the system is full of inconsistencies, bureaucratic challenges, and shortages of child welfare workers. There is also a tremendous lack of caring, competent foster families for the situations where children truly need placement in out-of-home care. The FFPSA offers an opportunity to fix some of these problems by diverting dollars to prevention. The FFPSA allows the use of Title IV-E funds for prevention services that may include substance abuse treatment and mental health services intending to keep children with their parents. States may opt to use funds in this manner for up to 12 months when a child is considered at-risk of out-of-home placement. 

These prevention services must meet an evidence threshold of supported or well-supported defined by the Title IV-E Prevention Services Clearinghouse. The initial cost of the Clearinghouse has been estimated at $1.8 million with a potential cost of $5.2 million by the end of the contract. Will this provide any actual answers for children in foster care, or will this be another research study that ends up having a negligible impact upon practice? Some practitioners are expressing frustration about the clearinghouse. They argue FFPSA failed to enable a review of existing congregate care providers that may have been effective. Instead, the act overhauls the system and has eliminated many providers nationally. Wiping out congregate outright is a type of solution, but that solution has created its own problems by eliminating much needed placements. 

The FFPSA limits reimbursements from the federal government to states for congregate care placements to 2 weeks. Even then, the congregate care placement must be in an approved setting known in the FFPSA as a qualified residential treatment program (QRTP).

On average, there were more than 418,000 American children placed in the foster care system each year from 2009 to 2018 (Children in foster care | KIDS COUNT Data Center). 

In 2020, a study by The Imprint found just over 214,000 licensed foster homes in the United States (Total Licensed Foster Homes 2019–2020 - Who Cares: A National Count of Foster Homes and Families ( 

What is clear is the foster care crisis is not improving much. Too many children are spending time in, out-of-home care. So much so that the number of foster homes in America cannot keep up with the demand for placements. They encourage placements to be with family, but there is also a lack of resources in many of these families that prevents large sibling groups from being cared for together. 

Will the FFPSA accomplish a true overhaul of the American child welfare system? 

It seems unlikely that such a heavy-handed approach to dealing with congregate care will produce enough appropriate foster care placement resources. Child welfare professionals are eager to see better outcomes for children. The FFPSA is a first step toward system overhaul, but it is unlikely there will be rapid and lasting change from the legislation.


Michael Smith

Dr. Michael Smith has been practicing social work nearly 30 years in a variety of settings. He has served as an item writer, exam reviewer, and content reviewer for social work licensure examinations for the Association of Social Work Boards since 2003. He has also served as Chair of the Alabama State Board of Social Work. Michael’s education includes a Bachelor of Social Work, Master of Social Work, and Master of Business Administration from the University of Alabama. Michael also earned the Doctor of Philosophy in Management from Walden University. He is a Licensed Independent Clinical Social Worker (LICSW) and holds a Private Independent Practitioner certificate (PIP) with endorsements in clinical social work, social work administration, social work research, social casework, and community organization.

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Opinions and viewpoints expressed in this article are the author's, and do not necessarily reflect those of CE Learning Systems.

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