Since Congress passed the Family First Prevention Services Act (FFPSA) in February 2018, stakeholders across the U.S. have been working to maximize the opportunity posed by this tremendous reform to our child welfare system. To ensure that children and families reap the positive benefits of FFPSA, service-providing agencies, social workers, child welfare officials, accrediting bodies, policy makers, and advocacy organizations have been rigorously planning for implementation, all while trying to keep up-to-date on the latest guidance and policy.
Looking for an FFPSA 101? Watch our informational video.
As COA began working with service providers impacted by FFPSA, we found that organizations were not only interested in information about the accreditation process, but also resources relevant to the larger scope of FFPSA provisions. That’s why we created the COA FFPSA Resource Center, a hub of FFPSA-related content including federal guidance, tools and resources, accreditation information, events and trainings, and news.
We are continually evolving the website as new guidance and/or policy is released and as states move forward with implementation. Have a resource, article, or tool that you’d like to see posted on the Resource Center? We’d love to hear from you! Reach out to us by email at PublicPolicy@coanet.org.
Just starting to peruse the site and not sure where to start? Fear not! We’ve created a list of 5 helpful resources to get you started.
1. Federal Requirement Comparison: QRTP and PRTF
From the Building Bridges Initiative
With the support of the Annie E. Casey Foundation, Building Bridges created this comparison to assist providers in understanding the federal requirements set forth for Qualified Residential Treatment Programs (QRTP) and Psychiatric Residential Treatment Facilities (PRTF). The information is organized in a table by requirement component, so that readers can do a line-by-line comparison of each program’s respective requirements. Though QRTPs and PRTFs have some similarities, these programs were created and defined separately in federal law in order to establish varying levels of care for children and youth with significant behavioral health needs.
Building Bridges is a national initiative working to identify and promote practices and policies that will create strong coordinated partnerships and collaborations between families, youth, community- and residentially-based treatment and service providers, advocates, and policy makers to ensure that comprehensive mental health services and supports are available to improve the lives of young people and their families.
View the comparison here.
2. Responsibly Defining Candidacy within the Context of FFPSA: 5 Principles to Consider
From the Center for the Study of Social Policy
The Center for the Study of Social Policy created this brief of guiding principles for states to consider as they work to identify a definition of foster care candidacy that fits within the context of their state policies and prevention service array.
FFPSA defines the term ‘child who is a candidate of foster care’ to mean “a child who is identified in a prevention plan under section 471(e)(4)(A) as being at imminent risk of entering foster care…but who can remain safely in the child’s home or in kinship placement as long as services of programs specified in section 471(e)(1) that are necessary to prevent the entry of the child into foster care are provided” (Sec. 50711). This means each state will be responsible for defining candidacy in their State IV-E Plan, which will be submitted to the Children’s Bureau. State definitions of “candidacy” will be extremely important in deciding which children and families will be served under FFPSA prevention services. This resource provides a guiding methodology for state policymakers in creating that definition and assists in considering the way such a policy will impact children and families in their state.
View the resource here.
3. Program Standards for Treatment Family Care
From the Family Focused Treatment Association (FFTA)
As we learn more about the impact that FFPSA implementation will have, it has become clear that there is a need to bolster the continuum of child welfare services offered to meet the needs of children and families. Treatment Family Care (TFC), also known as Treatment Foster Care (TFC), has emerged as a leading service to meet the behavioral needs of children in home-settings rather than residential care. The strict parameters established around residential placement under FFPSA puts a spotlight on TFC as a service that can maintain a residential level of care while keeping children and youth in a home-setting.
Though TFC services are provided across the country, federal guidance related to funding opportunities, practice standards, and program oversight has never been issued. Fortunately, Congress is currently considering the Treatment Family Care Services Act (HR3649 and S1880), which will provide states with a clear definition and guidance on federal TFC standards under the Medicaid program and other federal funding streams. This clarification will promote accountability for states offering TFC, support FFPSA implementation, promote appropriate TFC services for reimbursement, and drive personnel training and standards.
FFTA first published their own Program Standards for TFC in 1991 to define the model and set parameters for the field. In 2019, FFTA published the revised 5th edition, which provides several updates to the previous edition and in particular approaches the standards from a broader perspective of Treatment Family Care. This is in response to the changing needs of children, youth, and families; programmatic changes; and service expansions impacting TFC services. In particular, the new edition expands the view of TFC by integrating a focus on children living with kin. This inclusion was necessitated by an increasing expectation to meet the treatment needs of children in kin settings, stemmed by the belief that living with family can minimize the trauma associated with separation from parents.
View the FFTA’s program standards here.
4. Title IV-E Prevention Services Clearinghouse website
From the U.S. Administration for Children and Families (ACF)
The Title IV- E Prevention Services Clearinghouse was established in accordance with FFPSA by the Administration for Children and Families (ACF) within the U.S. Department of Health and Human Services (HHS). Its goal is to conduct an objective, rigorous, and transparent review of research on programs and services intended to support children and families and prevent foster care placements. Programs submitted to the Clearinghouse are rated as “well-supported”, “supported”, “promising practice”, or as “not meeting criteria”. The initial programs that have been rated include mental health services, substance abuse prevention and treatment services, in-home parent skill-based programs, and kinship navigator programs.
Ratings will help determine programs’ eligibility for reimbursement through Title IV-E funding. The Clearinghouse continues to be updated as new services are reviewed and rated, those interested in receiving real time notifications of updates can sign up here.
Access the Title IV-E Prevention Services Clearinghouse here.
5. National and state FFPSA news
From our FFPSA Resource Center
Implementation of FFPSA will mark the largest reform to our national child welfare system in decades. Since FFPSA passed in February 2018, there have been hundreds of news outlets reporting on the many components of reform at the national and state level, including information on implementation, related legislation, funding opportunities, service delivery, and more. The large scope of provisions can make it difficult to find the information that is relevant to your role in implementing FFPSA. That’s why COA created a FFPSA news round-up, updated regularly with content published related to state-specific activities and national news related to FFPSA.
State-level news can be viewed here and national-level news can be found here. Want to get alerts when important updates are published? Sign up for our mailing list.
We hope these resources will support you and your agency in learning more about the provisions of FFPSA. We would like to thank all of the organizations that have produced content to assist our field with this important legislation.
Though we’ve identified these five resources to get you started, we encourage you to continue your research and explore all of the information available at www.coafamilyfirst.org. And since we couldn’t pick just five…
Accreditor Comparison Guide
Needing to pursue national accreditation as a result of FFPSA? The first step is to find an accreditor that is the right fit for your organization. To support agencies in choosing an accreditor, we created a comparison guide that details the differences between the COA, CARF, and JC accreditation processes.
Download the comparison here.
“How Do You PQI?”
This is phrase that COA came up with a few years ago to introduce our newest toolkit. As an accreditation insider, we think it’s a clever phrase in that it conveys that:
- PQI is a necessity
- PQI is something that you do and that has motion, and
- PQI is customizable.
(We also like that it rolls off the tongue easily, unlike the word “accreditation.”)
Unfortunately, not everyone is an accreditation insider. We love our acronyms at COA, and use them everywhere–in our standards, in our process, in our technology (shout out to the VIP portal!). But acronyms and jargon can be confusing to anyone not in the know, and create barriers to understanding. “PQI” is no different.
So what is PQI, you ask?
Good question–and a common question we’re asked when staffing COA’s exhibit booth at a conference. The conversation usually goes something like this:
Inquiring person: What is PQI?
Us: It’s the foundation of the accreditation process.
Inquiring Person: Yes, but what does it mean?
Us: “Performance and Quality Improvement.” It’s our name for Quality Improvement or Quality Assurance.
Inquiring person: Thanks. What’s “Quality Improvement”?
Us: On a basic level, we like to say that a PQI system is collecting data about your work, analyzing it, making course-corrections based on the data, and then tracking to see if those changes are working.
Then we usually see a glimmer of understanding in their eyes. We give the inquiring person our PQI Toolkit postcard, and hope that it makes its way to the Quality Assurance/Data Nerd at their agency.
Based on our conversations with stakeholders, in-process organizations, and peers, we at COA know that PQI is can be a conceptual, difficult-to-grasp concept. We also know that agencies need a lot of help developing their PQI systems. This is why we talk about PQI a lot, and why we create trainings and tools to help.
One long-awaited tool is a high-level introduction to PQI for anyone new to the concept. Now when we’re manning the exhibit table and get asked “What is PQI?”, we are thrilled to be able to reply:
“Check out our PQI whiteboard video!”
The most effective social service organizations are those that have been accredited to meet the highest standards of quality.
For more than 40 years, the nonprofit Council on Accreditation has partnered with health and human service organizations globally to improve outcomes by developing, applying, and promoting accreditation standards.
COA’s Performance and Quality Improvement standards, or PQI, require organizations to generate and review organization-wide data to establish performance targets that improve services and outcomes for all stakeholders. It’s a comprehensive process that includes working with the entire organization instead of assigning the responsibility for quality improvement to just a few individuals.
Information generated by the PQI system is used to:
- Monitor progress toward achievement of strategic goals and long-term direction,
- Manage programs and operations efficiently and effectively,
- Meet funder requirements to promote the organization and its services throughout the community, and
- Support direct service staff to meet program goals and have a positive impact on people served.
The organization reviews findings and feedback while taking action to:
- Eliminate or reduce identified challenges,
- Replicate good practices,
- Recognize and motivate staff, and
- Improve services for the communities they serve and assist with fulfilling their mission.
And hopefully now you think the phrase “How Do You PQI?” is clever, too.
Want to dig deeper into PQI? Check out our comprehensive PQI Toolkit.