Before the Falls

For example, state and federal foster care funding has always been triggered by the removal of a child from their family and placed within some type of “foster care” setting. This same holds true for the juvenile justice system; probation doesn’t get involved until after a youth has committed an offense. Unfortunately, the government funding system has always been designed to prevent the use of foster care and juvenile justice dollars to Identify and Prevent entry into their systems. Public cost for providing the services have escalated dramatically resulting in state and federal efforts to reduce these cost – but predominantly in a misguided direction; attempting to shift youth to less expensive placements that usually don’t meet their needs, failing to focus on Early Identification and Prevention!

The Family Care Network has been very successful in providing treatment interventions and services to children and youth impacted by trauma, exclusively in a “Family-Based Services” model. I started the organization to prevent system kids from going into group homes and stay in a family-based treatment setting. But, too often I have thought or have had staff comment, “Wouldn’t it have been so much better to begin work with the youth and their family years earlier?” Again, we are constrained to stand at the base of the falls to help put their lives back together after they come tumbling down instead of stopping them from ever getting to those falls to begin with!

In an era of mostly bad news, there is some good news with regard to this early prevention issue! A few weeks ago, Congress passed a Continuing Budget Resolution to keep our government going for another short course of months. To many people’s surprise, nestled within the fine print of this massive bill was the Family First Preservation Services Act (FFPSA). FFPSA was legislation that many of us providers started pushing several years ago when it was initiated in the Senate Finance Committee by co-chairs Orrin Hatch and Ron Wyden. This first bill was derailed for many good and bad reasons, but it still found its way back to life this year.

FFPSA isn’t a perfect bill by any means, and it brings with it some big new challenges and a lot of very disgruntled people at the state and provider level. And, of course, the primary motivation behind the bill was to “reduce Foster Care Expenditures!” Like California’s Continuum of Foster Care Reform project of the last four or five years, the primary cost saving mechanism is to shift youth from group home/institutional care to family-based services, like those provided by the Family Care Network. From a treatment perspective and based on outcomes, this approach is better for foster youth anyway.

The most important feature of FFPSA, for the very first time ever, is that it allows states to utilize some of the Foster Care Funding for Early Detection, Intervention and Prevention treatment. Additionally, the bill also allows a carveout for “aftercare” services to prevent foster youth from re-entering the system. FFPSA also comes with some “new funding” to support these new services. As I already mentioned, there are plenty of caveats accompanying this legislation which will need to be addressed in the near future. But – it is a huge step in the right direction! Finally, I believe we can truly begin to deliver services “upstream” to prevent children and families from going over the falls!

From my years of experience with the Family Focused Treatment Association (FFTA), especially serving on their Board of Directors, I have come to realize that there are hundreds of high quality, high performance providers, like the Family Care Network, with the skills, experience and capacity to effectively serve in a preventative, early intervention capacity. Who is better equipped to work with families to prevent a disruption than organizations who have spent years repairing families, reunifying children with family and finding families for kids who don’t have them? Expanding these services is a dream come true!

There is definitely a ton of work which needs to be done and to fully implement FFPSA, and it is exciting to know that the resource is there to make it work successfully. While the “nuts and bolts” are being put together over the next few years for full implementation, it is incumbent upon the provider community, working with their state and county partners, to create a successful framework to achieve FFPSA outcomes. Dedicating to this goal will require building practice models in three areas of service:

The first is Early Identification. FFPSA success will be contingent upon the effectiveness of Early Identification, which will entail developing systems within the schools, therapeutic and medical communities, law enforcement, child welfare services and probation. There are existing effective models to replicate, and significant research to help support developing or refining new models. The most important part of this effort will be to begin now and not wait for two years for the program’s initial implementation.

The second involves Treatment Services and Interventions. The bill specifies certain types of treatment interventions and the use of evidence-based practices to help achieve high efficacy. It is important to begin creating a constellation of proven practices which can be applied to address a broad array of issues and family challenges. Additionally, FFPSA involves the utilization of federal Foster Care funding, providers and their government partners would be wise to begin to craft treatment and intervention models that may also incorporate EPSDT Children’s Specialty Mental Health and Health Care Services funding. The goal to is to leverage every source of funding available to enhance family success.

The third is creating enhancements to Aftercare and Post-Placement Services and Supports. There are currently an array of practices being applied in an aftercare function, but these need to be reevaluated and greatly enhanced. Research has demonstrated that there is a strong degree of ineffectiveness in post-placement aftercare which results in too many youth returning to the system. Very often, agencies like mine, do great work in getting kids back to family and then the service door slams shut. Again, now is the time to rethink this practice model and weave the pieces together to make this system of care much more substantial.

For nearly 50 years, I have had a vision and drive to see services are brought to children and families as early as possible, to keep them out of the foster care and juvenile justice systems. Now, it finally seems like the opportunity has dawned. Let us all seize the moment, make it a great success, and stop children and youth from unnecessarily tumbling down the waterfall into pain, heartbreak and trauma!