A Two-Part Overview and Application | A National Perspective and a State Perspective
Part 1 | A National Perspective with Shelia Pires
Guest Sheila Pires, Managing Partner, Human Service Collaborative Core Partner, National TA Network for Children’s Behavioral Health, speaks with former CIP Director and Innovative Conversations host, Patrick Kanary present a national perspective discussing the Family First Prevention Services Act (FFSPA). It is the first installment of a two-part discussion, the second of which will explore Family First from a state-wide perspective in Ohio with Ohio specialists Carla Carpenter, Angela Sausser and Crystal Ward Allen. To listen to FFSPA Part 2, click here.
(To View Full Size Images from PowerPoint presentation, click on pic to enlarge and read.)
The Center for Innovative Practices (CIP), part of the Begun Center for Violence Prevention at the Mandel School of Applied Social Sciences at Case Western Reserve University, has developed a podcast initiative entitled, Innovative Conversations, exploring topics pertaining to the CIP mission of identifying promising practices and evidence-based interventions for youth dealing with mental health, substance use, trauma, and judicial justice challenges. Hosted by first CIP director Patrick Kanary, the series also examines how Wraparound Systems of Care can better facilitate how integrated treatment can help yield optimal outcomes with youth recovery.
View Innovative Conversation Webinar Session on Family First | View FFPSA Powerpoint Presentation
This session involves the Family First Prevention Services Act (FFPSA) and what it means to states funding in-home treatment and recovery for at-risk you dealing with the challenges of mental health, substance use, trauma, and judicial justice issues.
The Family First Prevention Services Act was signed into law as part of the Bipartisan Budget Act on February 9, 2018. This act reforms the federal child welfare financing streams, Title IV-E and Title IV-B of the Social Security Act, to provide services to families who are at risk of entering the child welfare system.
The bill aims to prevent children from entering foster care by allowing federal reimbursement for mental health services, substance use treatment, and in-home parenting skill training to families and children. It also seeks to improve the well-being of children already in foster care by incentivizing states to reduce placement of children in group care.
In her presentation and ensuing discussion with Patrick Kanary, Sheila Pires identifies two major related goals: Funding for prevention services and the Limits on use of congregate care. Prevention Services Allows use of Title IV-E for Prevention Services and Supports (i.e., to prevent placement of children and youth into foster care and placement disruption for children/youth in adoptive or kinship guardian homes).
In addition, IV-E reimbursement allowed for up to 12 months for a child placed with a parent in a licensed residential family-based treatment facility for substance abuse, regardless of whether child meets AFDC income eligibility, which became effective Oct 2018.
Prevention Services Eligibility
Populations eligible to receive services include: 1) Parents or relatives caring for children/youth who are “candidates for foster care” – at imminent risk of entering foster care but can remain safely at home with services and supports 2) Adoptive parents and relative guardians where placement disruption is issue 3) Youth in foster care who are pregnant or already parents and 4) Eligible children, youth, parents and kinship caregivers are eligible for services regardless of whether they meet the AFDC income eligibility requirements for IV-E reimbursement.
Extending to age 23, this supports the youth population transitioning out of foster care. It also extends to age 26 the eligibility for education and training vouchers (Chafee Foster Care Independence Program).

Prevention Services
Prevention services and supports must be promising practice, supported practice, or well-supported practices, with 50% of expenditures for prevention services being for well-supported practices.
Funds also can be used for training and administration related to the provision of prevention services and supports, including data collection and reporting
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Federal Match
Between October 1, 2019 and Oct 1 2026, there is a 50% Federal IV-E match for prevention services. Beginning Sept 30 2026, Federal IV-E match for prevention services will be the same as the state’s Federal Medicaid match rate
Maintenance of Effort
States cannot spend less than they did in FY 2014 on prevention services, i.e., cannot substitute FFPSA dollars for state and local prevention expenditures

ABOUT THE PRESENTER
Sheila A. Pires is a founding partner of the Human Service Collaborative of Washington, D.C., a policy and technical assistance group specializing in child and family service systems. Ms. Pires has over 35 years of experience in national, state, and local government and non-profit agencies serving children, youth and families at risk.
She has held senior staff and management positions in the U.S. House of Representatives, the U.S. Department of Health, Education and Welfare and the Carter White House. She co-chaired the children’s mental health and substance abuse committee of President Clinton’s Task Force on Health Care Reform and co-authored the children’s issue brief and policy recommendations for President Bush’s New Freedom Mental Health Commission.
In the Obama Administration, she was invited to present on children’s behavioral health at the Center for Medicare and Medicaid Services Grand Rounds. She serves as the Senior Consultant to the Children in Managed Care and Child Health Quality Programs at the Center for Health Care Strategies and is a core partner of the National Technical Assistance Network for Children’s Behavioral Health, co-leading the Network’s work on policy, system design and financing.
Ms. Pires served as Deputy Commissioner of Social Services for the District of Columbia and led a reorganization of the city’s child mental health system as head of child mental health services. She has consulted with most states, as well as counties, cities, neighborhoods, foundations, and family-run organizations, and has authored numerous publications on systems change, including Building Systems of Care: A Primer.
She has served on the National Board of the Federation of Families for Children’s Mental Health and currently is on the National Advisory Council of the Hogg Foundation for Mental Health. Ms. Pires received her B.A. from Boston University and a Master of Public Administration from Harvard University.
Additional Resources
Family First Prevention Services Act (P.L. 115-123)
https://comm.ncsl.org/productfiles/112498833/PPT_Christine_Calpin.pdf
FamilyFirstAct.org
https://www.familyfirstact.org/
Family First Advocacy Toolkit | American Academy of Pediatrics
https://www.familyfirstact.org/source/american-academy-pediatrics
National Conference of State Legislatures
http://www.ncsl.org/research/human-services/family-first-prevention-services-act-ffpsa.aspx
Information Memorandum on Family First (IM-18-02)
https://www.acf.hhs.gov/cb/resource/im1802
Program Instruction – Implementation of Title IV-E Plan Requirement
https://www.cwla.org/wp-content/uploads/2018/12/ACYF-CB-PI-18-09-State-FFPSA-Prevention-PI.pdf
Child Welfare Community Letter – October 1, 2018
https://wraparoundohio.org/wp-content/uploads/2019/05/Child-Welfare-Community-FFPSA.pdf
Program Instruction – State Title IV-E Prevention and Family Services and Programs
https://www.acf.hhs.gov/cb/resource/pi1809
Program Instruction – Tribal Title IV-E Agency Requirements for Electing Title IV-E Prevention and Family Services and Programs
https://www.acf.hhs.gov/cb/resource/pi1810
State Child Welfare Director Letter – January 2, 2019
https://www.acf.hhs.gov/cb/resource/letter-title-iv-e-prevention-clearinghouse
FamilyFirstAct.org
https://www.familyfirstact.org/
Family First Advocacy Toolkit | American Academy of Pediatrics
https://www.familyfirstact.org/source/american-academy-pediatrics
Innovative Conversation Session 7 | A State of Ohio Perspective on the Family First Prevention Services Act (FFSPA)
Guests Crystal Ward Allen, MSW, LSW, Senior Director and Strategic Consulting with Casey Family Programs, Carla Carpenter, Deputy Director of the Office of Families and Children (OFC) at the Ohio Department of Job and Family Services, and Angela Sausser, Executive Director at the Public Children Services Association of Ohio, speaks with former CIP Director and Innovative Conversations host, Patrick Kanary presenting an Ohio overview discussing the Family First Prevention Services Act (FFSPA) and its impact on the state and its communities. It is the second installment of a two-part discussion, the first of which will explored Family First from a national perspective with national expert dealing with youth and families at risk, Sheila Pires, which you can listen to and experience by clicking here.
THE LAST FEW YEARS have been extremely challenging times for Ohio’s child protection services agencies. The burgeoning opioid epidemic in tandem with ongoing child protection needs, have set record increases of youths entering the foster care system.
View and Download PDF of FFPSA in Ohio Overview
Listen to A State of Ohio Perspective on the Family First Prevention Services Act (FFSPA)
For years, Ohio’s child protection services have been underfunded by the state, relying mainly on local levies and other resources.
(Click on pics to enlarge and view more directly.)
Nevertheless, there is reason for hope with the passage of Ohio’s biennium budget (FY 20-21) under Governor DeWine along with significant changes at the federal level of use of funding in the child protection system through the Family First Prevention Services Act (FFSPA).
View Innovative Conversation Webinar Session on Family First Part 1 | View FFPSA Powerpoint Presentation from Part 1
As studies show, kids do best in a family structure, be it biologically primary or extended family and the FFSPA allows states to focus unlimited reimbursements to states to provide in-home services for these struggling families, assistance ranging from in-home parenting skills and home-visits to mental health services, trauma recovery, and substance abuse services for care givers or adolescents.
This session of, Innovative Conversations, involves Part 2 involving the Family First Prevention Services Act (FFPSA) and what it means to states funding in-home treatment and recovery for at-risk youth dealing with the challenges of mental health, substance use, trauma, and judicial justice issues.
Ohio recently passed its FY 20-21 budget and many have observed what a child and family friendly budget this is. One area of increased support was to county children’s services authorities, raising the question: What will this increase do to improve things at the local level? What is the relationship between the state funded increases and those funds anticipated from FFPSA?
Ohio Title IV-E Waiver (ProtectOHIO)
http://jfs.ohio.gov/ocf/pohio.stm
Additional questions this Innovative Conversation session addresses include:

• What prompted the move to create this change in funding requirements?
• What does it mean that Ohio has been designated a “IV-E Waiver” state; what does this mean and how this is related to FFPSA?
• Who are the partners?
• Are families represented? What does the timeline look like?
• And what is the relationship between FFPSA and Medicaid, since both fund community-based services?
• What are the eligibility requirements for these funds? Are there specific population groups that are the focus?
• What do you see as the main opportunities here in Ohio for implementation of FFPSA? What is happening in our state that could benefit from the infusion of these funds?
• What do you see as the particular opportunities under FFSPA for child and family behavioral health? (Full disclosure here…I am on the mental health subcommittee of the state’s planning process)
• What kind of flexibility will Ohio have on what services the states wants to use this funding for? What services have already been approved via the registry?
• What do we hear from local children’s services about the emerging program priorities?
• Will there be requirements around what and how are outcomes determined or measured?
• Since the focus is on prevention and essentially community and home-based care, what restrictions are there regarding out of home placement or congregate care?
• What challenges lie ahead regarding implementation?
The Family First Prevention Services Act was signed into law as part of the Bipartisan Budget Act on February 9, 2018. This act reforms the federal child welfare financing streams, Title IV-E and Title IV-B of the Social Security Act, to provide services to families who are at risk of entering the child welfare system.
The bill aims to prevent children from entering foster care by allowing federal reimbursement for mental health services, substance use treatment, and in-home parenting skill training to families and children. It also seeks to improve the well-being of children already in foster care by incentivizing states to reduce placement of children in group care.
ABOUT THE PRESENTERS

Crystal Ward Allen
Crystal Ward Allen, MSW, LSW, Senior Director and Strategic Consulting with Casey Family Programs, is a strategic consultant, working with the child welfare communities primarily in Colorado and Ohio to strengthen families and reduce the need for foster care. She has been with Casey Family Programs since spring of 2014, after 24 years working with the child welfare system in Ohio, as well as early years as a juvenile probation counselor in Appalachia, VA; adolescent group care in Pittsburgh, PA; and child welfare in suburban Minnesota. She is a Va. Tech Hokie as well as an OSU Buckeye, loves to ride her bike, hike and enjoy music – but most importantly she has two amazing adult children. Crystal is passionate about ensuring every child and youth has someone that is unconditionally crazy about them – thus, strengthening families is a must

Carla K. Carpenter
As Deputy Director of the Office of Families and Children (OFC) at the Ohio Department of Job and Family Services, Ms. Carpenter serves as the State Child Welfare Director for Ohio. OFC is responsible for oversight of child abuse prevention, protective services, foster care, and adoption services as well as adult protection services across the state. Since joining the Department in 2010 as Statewide Differential Response Manager and then serving as Bureau Chief of Systems and Practice Advancement, Ms. Carpenter has focused on working in collaboration with system partners to implement innovative programming and improve outcomes. Prior to coming to the Department, Ms. Carpenter served as Associate Director of the National Center for Adoption Law & Policy (now the Family &Youth Law Center) at Capital University Law School. She also brings broad experience working in a variety of direct services settings with families and children. She has a bachelor’s degree in social work from Capital University in Columbus and a master’s degree in social work from Columbia University in New York.

Angela Sausser
Angela Sausser is Executive Director at the Public Children Services Association of Ohio. Angela was the chief of the Bureau of Children and Families for the Ohio Department of Mental Health and Addiction Services, overseeing funding, programs, and initiatives related to the mental health and addiction needs of children and their families. Angela served as the project director for the department’s four-year federal grant called ENGAGE (Engaging the New Generation to Achieve their Goals through Empowerment) focused on expanding systems of care for youth and young adults. Finally, Angela retained her governor-appointed position as the director of Ohio Family and Children First Cabinet Council, a post she held throughout her state government career of nine years. There, Angela worked in partnership with the health and human services Cabinet agencies, the Governor and First Lady’s offices, and the Office of Health Transformation to improve the coordination of services for children and their families. Angela was responsible for convening planning, policy, and fiscal teams to address cross-system issues; providing guidance and technical assistance to the 88 county Family and Children First Councils (FCFCs); and communicating with state officials, agencies, and community partners about issues, policies and funding impacting children and families.
Additional Resources
Family First Prevention Services Act (P.L. 115-123)
https://comm.ncsl.org/productfiles/112498833/PPT_Christine_Calpin.pdf
FamilyFirstAct.org https://www.familyfirstact.org/
Family First Advocacy Toolkit | American Academy of Pediatrics
https://www.familyfirstact.org/source/american-academy-pediatrics
National Conference of State Legislatures
http://www.ncsl.org/research/human-services/family-first-prevention-services-act-ffpsa.aspx
Information Memorandum on Family First (IM-18-02)
https://www.acf.hhs.gov/cb/resource/im1802
Program Instruction – Implementation of Title IV-E Plan Requirement
https://www.cwla.org/wp-content/uploads/2018/12/ACYF-CB-PI-18-09-State-FFPSA-Prevention-PI.pdf
Child Welfare Community Letter – October 1, 2018
https://www.wraparoundohio.org/wp-content/uploads/2019/05/Child-Welfare-Community-FFPSA.pdf
Program Instruction – State Title IV-E Prevention and Family Services and Programs
https://www.acf.hhs.gov/cb/resource/pi1809
Program Instruction – Tribal Title IV-E Agency Requirements for Electing Title IV-E Prevention and Family Services and Programs
https://www.acf.hhs.gov/cb/resource/pi1810
State Child Welfare Director Letter – January 2, 2019
https://www.acf.hhs.gov/cb/resource/letter-title-iv-e-prevention-clearinghouse
FamilyFirstAct.org
https://www.familyfirstact.org/
Family First Advocacy Toolkit | American Academy of Pediatrics
https://www.familyfirstact.org/source/american-academy-pediatrics
ODJFS FFPSA information
http://jfs.ohio.gov/ocf/Family-First.stm
FFPSA Clearinghouse
https://preventionservices.abtsites.com/
Family First Resources
https://www.familyfirstact.org/
Family First Supporting Evidence Opportunity
https://www.familyfirstact.org/resources/supporting-evidence-building-child-welfare-project
Ohio Title IV-E Waiver (ProtectOHIO)
http://jfs.ohio.gov/ocf/pohio.stm
PCSAO Continuum of Care Reform
https://www.pcsao.org/public-policy/continuum-reform
Ohio START
https://www.pcsao.org/programs/ohio-start
Family First Prevention Services Act. Statutory language, 2018 H.R. 1892. See pp. 169 to 206.
https://www.congress.gov/115/bills/hr1892/BILLS115hr1892enr.pdf
U.S. House of Representatives, Ways & Means Committee Report. Provides background regarding Congressional intent. https://www.congress.gov/114/crpt/hrpt628/CRPT-114hrpt628.pdf
Federal HHS Program Instruction. ACYF-CB-PI-18-07, Issued July 9, 2018, with related attachments.
https://www.acf.hhs.gov/cb/resource/pi1807
Federal Register. Notice for Proposed Model Family Foster Home Licensing Standards, including a summary of the proposed model standards.
https://www.federalregister.gov/documents/2018/08/01/2018-16380/noticefor-proposed-model-family-foster-home-licensing-standards

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