2 8 1 Healthcare Program/Policy Evaluation Analy Promoting Safe and Stable Families The role of nurses throughout healthcare program and policy evaluation is vital to our role as change agents within our communities. As nurses we participate in the evaluation process every time we go to work, assess our patients, and then partake in delivery of care. If we want to our voices to be heard we must be willing to take our evaluation skills to the next level. We must ask ourselves tough questions about whether the healthcare programs we are providing are meeting the needs of patients, their families, and communities. We must evaluate the healthcare program goals and outcomes to help determine whether it remains fiscally responsible and continues to meet a need in the population it aims to serve. Ultimately, we cannot blindly accept that the presence of a program validates its success. We must be willing and able to take personal action to ensure patients receive the highest quality of healthcare each and every day. The purpose of this paper is to present an evaluation of the Promoting Safe and Stable Families (PSSF) program with respect to it’s background, goals, outcomes, success, costs and related nursing advocacy opportunities. Healthcare Program/Policy Evaluation Promoting Safe and Stable Families (PSSF) Description The Promoting Safe and Stable Families (PSSF) program, which is more formally known as Title IV-B subpart 2 of the Social Security Act, aims to avoid unnecessary separations between caregivers and their children, protect permanency for children by taking the necessary steps to reunite them with their parents, when possible, or another permanent living situation, and to improve the quality of care and programming services being offered to children and their families to achieve maximum chance for stable families (U.S. Department of Health & Human Services: Children’s Bureau, 2012). The PSSF program has recently had two additional programs added, the Personal Responsibility Education Program (PREP) and abstinence education. The goal of the PREP program is to provide state funding aimed at teen pregnancy prevention, addressing prevalence of sexually transmitted infections (STIs) in the adolescent population, as well as teaching teens skills to prepare them for adulthood (ie financial responsibility and organization skills). The abstinence education portion provides grants to individual states to promote education to adolescents regarding delaying sexual activity in an effort to further reduce teen pregnancy rates, but also to promote development of healthy relationships and establishment of healthy boundaries in at-risk populations such as homeless teens or those in foster care (United States Department of Health & Human Services, 2018). How was the success of the program or policy measured? Success of the PSSF program has been measured by the fact that funding for this program became a ma ...

1. 2
8
1
Healthcare Program/Policy Evaluation Analy
Promoting Safe and Stable Families
The role of nurses throughout healthcare program and
policy evaluation is vital to our role as change agents within our
communities. As nurses we participate in the evaluation
process every time we go to work, assess our patients, and then
partake in delivery of care. If we want to our voices to be heard

2. we must be willing to take our evaluation skills to the next
level. We must ask ourselves tough questions about whether the
healthcare programs we are providing are meeting the needs of
patients, their families, and communities. We must evaluate the
healthcare program goals and outcomes to help determine
whether it remains fiscally responsible and continues to meet a
need in the population it aims to serve. Ultimately, we cannot
blindly accept that the presence of a program validates its
success. We must be willing and able to take personal action to
ensure patients receive the highest quality of healthcare each
and every day. The purpose of this paper is to present an
evaluation of the Promoting Safe and Stable Families (PSSF)
program with respect to it’s background, goals, outcomes,
success, costs and related nursing advocacy opportunities.
Healthcare Program/Policy Evaluation
Promoting Safe and Stable Families (PSSF)
Description
The Promoting Safe and Stable Families (PSSF) program, which
is more formally known as Title IV-B subpart 2 of the Social
Security Act, aims to avoid unnecessary separations between
caregivers and their children, protect permanency for children
by taking the necessary steps to reunite them with their parents,
when possible, or another permanent living situation, and to
improve the quality of care and programming services being
offered to children and their families to achieve maximum
chance for stable families (U.S. Department of Health & Human
Services: Children’s Bureau, 2012).
The PSSF program has recently had two additional programs
added, the Personal Responsibility Education Program (PREP)
and abstinence education. The goal of the PREP program is to
provide state funding aimed at teen pregnancy prevention,
addressing prevalence of sexually transmitted infections (STIs)

3. in the adolescent population, as well as teaching teens skills to
prepare them for adulthood (ie financial responsibility and
organization skills). The abstinence education portion provides
grants to individual states to promote education to adolescents
regarding delaying sexual activity in an effort to further reduce
teen pregnancy rates, but also to promote development of
healthy relationships and establishment of healthy boundaries in
at-risk populations such as homeless teens or those in foster
care (United States Department of Health & Human Services,
2018).
How was the success of the program or policy measured?
Success of the PSSF program has been measured by the fact that
funding for this program became a mandatory component of the
Administration for Children and Families (ACF) within the U.S.
Department of Health and Human Services (HHS). The PSSF
program has been reauthorized multiple times over the past 25
years and continues to be nationally implemented. Congress
realized the success of this program, and ultimately the impact
it has had on children, adolescents, and their respective
families. Congress then began to require a budgetary
commitment of mandatory funds toward this program to be
awarded at the state level and to Native American tribes within
the states who meet minimum requirements for award. To
illustrate the success of the program in funding it is important
to recognize that in 1994, $60 million was allocated in
mandatory financial funding (Casey Family Programs, 2011),
and in 2019, $345 million has been allocated (United States
Department of Health & Human Services: Administration for
Children and Families, 2019).
In the state of Colorado, in fiscal year 2016, the following data
applied to the measurement of success of PSSF:
· 3,315 individuals were served by family preservation funds

4. · 3,023 individuals were served by family support funds
· 1,401 individuals were served by time-limited reunification
funds
(Colorado Office of Children, Youth, & Families: Division of
Child Welfare, 2018, p. 53)
How many people were reached by the program or policy
selected? How much of an impact was realized with the program
or policy selected?
Funding for PSSF is based on a formula that considers the
population of children who receive Supplemental Nutrition
Assistance Program (SNAP) aka “food stamps” in each state and
respective Native American tribe. In order to remain eligible
for PSSF funding each state must match 25% of the PSSF award
amount in a Maintenance of Effort (MOE) account (State of
California Health and Human Services Agency, 2014).
While the formula for determination of PSSF funding was not
available, nationally one in four children receive SNAP benefits
in a given month. This translates into between 20 and 22
million children receiving SNAP benefits in a given year.
While not all of these children will need PSSF funding dollars
these are the figures for which the state funding is determined
(Center on Budget and Policy Priorities, 2017).
What data was used to conduct the program or policy
evaluation?
PSSF funding is determined based on 5-year plans within each
state and Native American tribe. Analysis of program outcome
data is conducted annually at the individual state level in
alignment with the PSSF assurances, which include spending in
in alignment with state and federal statutes.

5. Each state and tribe must submit their intended goals with PSSF
funding. Each of the submitted plans must take into account
collaborative efforts with key stakeholders. Title IV-B requires
that PSSF plans be integrated into the state and/or tribal
agency’s 5-year Child and Family Services Plan (CFSP) and
provide annual updates by June 30th each year. The regional
Children’s Bureau offices are responsible for communication
and feedback to the respective states or tribes related to the
annual reports.
What specific information on unintended consequences were
identified?
Unintended consequences that have been identified since this
program began in 1993 is that the program which began as a
response to the growing number of children in foster care
placement has expanded over the last 25 years and has been
reauthorized under different legislative acts, most recently the
Child and Family Services Improvement and Innovation Act of
2011. At current this program addresses permanency of
children, Personal Responsibility Education Program and
abstinence education (United States Health & Human Services:
Administration for Children and Families, 2015).
What stakeholders were identified in the evaluation of the
program or policy? Who would benefit most from the results
and reporting of the program or policy evaluation? Be specific
and provide examples.
Stakeholders identified in the evaluation of the PSSF program
include
· Department of Human Services in each state and each county
· Native American tribes

6. · Vulnerable families with children at risk for abuse and/or
neglect
· Families with open child protection cases; either court
involved or non-court involved
· Foster parents
· Adoptive parents
· Hospitals and clinics
· Physicians and other healthcare providers
· Schools
· Teachers
· Law Enforcement
· Courts
· Community members
All of the stakeholders listed above will benefit from the results
of PSSF program evaluation because the results will impact the
direction for future grant funding for children and adolescents
with regard to foster care, permanency, PREP, and abstinence
education.
Did the program or policy meet the original intent and
objectives? Why or why not?
The PSSF program has met it’s intended objectives over
multiple years. However, the population it serves is constantly
changing and the objectives are fluid based on the legislative
source of funding, so the measure of success is a target that is
constantly moving and difficult to assess.
Would you recommend implementing this program or policy in
your place of work? Why or why not?
This program is already implemented in the state of Colorado
and provides funding for valuable resources for children and
adolescents within our state.

7. I would recommend implementation of this program because it
aims to preserve the structure of families, provide family
support to vulnerable families, provide time-limited
reunification support, provide skills, guidance, and education
for adulthood. Dividing families and removing children from
their biological parents changes the heritage of a family forever.
The PSSF program provides tools to prevent the division of
families whenever possible.
Identify at least two ways that you, as a nurse advocate, could
become involved in evaluating a program or policy after one
year of implementation.
In the role of a nurse advocate we can become involved in
evaluation of a program via multiple different avenues. For
example, nurses can volunteer to participate in the program
planning committee that focuses on evaluation of the program
one year after implementation. By becoming involved at this
level nurses can help to influence discussions regarding needs
for modification to the program in order to help make it more
successful. Nurses can also participate in program evaluation
by contacting legislators who support the program in order to
provide a nursing perspective relative to the program.
Conclusion
The healthcare program evaluated for the purposes of this paper
was the Promoting Safe and Stable Families (PSSF). During the
course of research for this paper it was challenging to find al l of
the data for completion of the above table. The background,
data, goals, and outcomes were not presented in a
comprehensive way that made evaluation clear and concise. As
research carried on it became apparent why being involved in
program evaluation in person and in real time is imperative to
success of the evaluation process. While evaluation of this

8. program was challenging it was meaningful in that the impact of
this program over the last 25 years became obvious. The PSSF
program is proof that programs can withstand the test of time as
long as modifications can be made along the way to continue to
best meet the needs of the target population and take into
account the evolving desires of the key stakeholders.
References
Casey Family Programs. (2011). The Promoting Safe and Stable
Families Program: Background and Context. Retrieved from
http://www.casey.org/media/PromotingSafeandStableFamilies.p
df
Center on Budget and Policy Priorities. (2017). SNAP Helps
Millions of Children. Retrieved from
https://www.cbpp.org/research/food-assistance/snap-helps-
millions-of-children
Colorado Office of Children, Youth, & Families: Division of
Child Welfare. (2018). 2018 Annual Progress and Services
Report: 2015-19 Child and Family Services Plan. Retrieved
from http://co4kids.org/sites/default/files/IM-CW-2017-
0018.pdf
State of California Health and Human Services Agency. (2014).
Promoting Safe and Stable Families Program. Retrieved from
http://www.childsworld.ca.gov/res/OCAP/PSSFFactSheet.pdf
United States Department of Health & Human Services. (2018).
Administration for Children and Families (ACF): Mandatory.
Retrieved from
https://www.hhs.gov/about/budget/fy2018/budget-in-
brief/acf/mandatory/index.html#promoting
United States Department of Health & Human Services:
Administration for Children and Families. (2019). FY 2019
Justification of Estimates for Appropriations Committees.
Retrieved from
https://www.acf.hhs.gov/sites/default/files/olab/acf_master_cj_a
cf_final_3_19_0.pdf
United States Health & Human Services: Administration for

9. Children and Families. (2015). Promoting Safe and Stable
Families. Retrieved from
https://library.childwelfare.gov/cwig/ws/library/docs/capacity/B
lob/105742.pdf?r=1&rpp=10&upp=0&w=+NATIVE%28%27rec
no%3D105742%27%29&m=1
U.S. Department of Health & Human Services: Children’s
Bureau. (2012). Promoting Safe and Stable Families: Title IV-
B, Subpart 2, of the Social Security Act. Retrieved from
https://www.acf.hhs.gov/cb/resource/pssf-title-iv-b-subpart-2-
ssa
1
1

10. 2
8
1
Healthcare Program/Policy Evaluation Analy

11. Promoting Safe and Stable Families
The role of nurses throughout healthcare program and
policy evaluation is vital to our role as change agents within our
communities. As nurses we participate in the evaluation
process every time we go to work, assess our patients, and then
partake in delivery of care. If we want to our voices to be heard
we must be willing to take our evaluation skills to the next
level. We must ask ourselves tough questions about whether the
healthcare programs we are providing are meeting the needs of
patients, their families, and communities. We must evaluate the
healthcare program goals and outcomes to help determine
whether it remains fiscally responsible and continues to meet a
need in the population it aims to serve. Ultimately, we cannot
blindly accept that the presence of a program validates its
success. We must be willing and able to take personal action to
ensure patients receive the highest quality of healthcare each
and every day. The purpose of this paper is to present an
evaluation of the Promoting Safe and Stable Families (PSSF)
program with respect to it’s background, goals, outcomes,
success, costs and related nursing advocacy opportuni ties.
Healthcare Program/Policy Evaluation
Promoting Safe and Stable Families (PSSF)
Description
The Promoting Safe and Stable Families (PSSF) program, which
is more formally known as Title IV-B subpart 2 of the Social
Security Act, aims to avoid unnecessary separations between
caregivers and their children, protect permanency for children
by taking the necessary steps to reunite them with their parents,
when possible, or another permanent living situation, and to
improve the quality of care and programming services being
offered to children and their families to achieve maximum

12. chance for stable families (U.S. Department of Health & Human
Services: Children’s Bureau, 2012).
The PSSF program has recently had two additional programs
added, the Personal Responsibility Education Program (PREP)
and abstinence education. The goal of the PREP program is to
provide state funding aimed at teen pregnancy prevention,
addressing prevalence of sexually transmitted infections (STIs)
in the adolescent population, as well as teaching teens skills to
prepare them for adulthood (ie financial responsibility and
organization skills). The abstinence education portion provides
grants to individual states to promote education to adolescents
regarding delaying sexual activity in an effort to further reduce
teen pregnancy rates, but also to promote development of
healthy relationships and establishment of healthy boundaries in
at-risk populations such as homeless teens or those in foster
care (United States Department of Health & Human Services,
2018).
How was the success of the program or policy measured?
Success of the PSSF program has been measured by the fact that
funding for this program became a mandatory component of the
Administration for Children and Families (ACF) within the U.S.
Department of Health and Human Services (HHS). The PSSF
program has been reauthorized multiple times over the past 25
years and continues to be nationally implemented. Congress
realized the success of this program, and ultimately the impact
it has had on children, adolescents, and their respective
families. Congress then began to require a budgetary
commitment of mandatory funds toward this program to be
awarded at the state level and to Native American tribes within
the states who meet minimum requirements for award. To
illustrate the success of the program in funding it is important
to recognize that in 1994, $60 million was allocated in

13. mandatory financial funding (Casey Family Programs, 2011),
and in 2019, $345 million has been allocated (United States
Department of Health & Human Services: Administration for
Children and Families, 2019).
In the state of Colorado, in fiscal year 2016, the following data
applied to the measurement of success of PSSF:
· 3,315 individuals were served by family preservation funds
· 3,023 individuals were served by family support funds
· 1,401 individuals were served by time-limited reunification
funds
(Colorado Office of Children, Youth, & Families: Division of
Child Welfare, 2018, p. 53)
How many people were reached by the program or policy
selected? How much of an impact was realized with the program
or policy selected?
Funding for PSSF is based on a formula that considers the
population of children who receive Supplemental Nutrition
Assistance Program (SNAP) aka “food stamps” in each state and
respective Native American tribe. In order to remain eligible
for PSSF funding each state must match 25% of the PSSF award
amount in a Maintenance of Effort (MOE) account (State of
California Health and Human Services Agency, 2014).
While the formula for determination of PSSF funding was not
available, nationally one in four children receive SNAP benefits
in a given month. This translates into between 20 and 22
million children receiving SNAP benefits in a given year.
While not all of these children will need PSSF funding dollars
these are the figures for which the state funding is determined
(Center on Budget and Policy Priorities, 2017).
What data was used to conduct the program or policy

14. evaluation?
PSSF funding is determined based on 5-year plans within each
state and Native American tribe. Analysis of program outcome
data is conducted annually at the individual state level in
alignment with the PSSF assurances, which include spending in
in alignment with state and federal statutes.
Each state and tribe must submit their intended goals with PSSF
funding. Each of the submitted plans must take into account
collaborative efforts with key stakeholders. Title IV-B requires
that PSSF plans be integrated into the state and/or tribal
agency’s 5-year Child and Family Services Plan (CFSP) and
provide annual updates by June 30th each year. The regional
Children’s Bureau offices are responsible for communication
and feedback to the respective states or tribes related to the
annual reports.
What specific information on unintended consequences were
identified?
Unintended consequences that have been identified since this
program began in 1993 is that the program which began as a
response to the growing number of children in foster care
placement has expanded over the last 25 years and has been
reauthorized under different legislative acts, most recently the
Child and Family Services Improvement and Innovation Act of
2011. At current this program addresses permanency of
children, Personal Responsibility Education Program and
abstinence education (United States Health & Human Services:
Administration for Children and Families, 2015).
What stakeholders were identified in the evaluation of the
program or policy? Who would benefit most from the results

15. and reporting of the program or policy evaluation? Be specific
and provide examples.
Stakeholders identified in the evaluation of the PSSF program
include
· Department of Human Services in each state and each county
· Native American tribes
· Vulnerable families with children at risk for abuse and/or
neglect
· Families with open child protection cases; either court
involved or non-court involved
· Foster parents
· Adoptive parents
· Hospitals and clinics
· Physicians and other healthcare providers
· Schools
· Teachers
· Law Enforcement
· Courts
· Community members
All of the stakeholders listed above will benefit from the results
of PSSF program evaluation because the results will impact the
direction for future grant funding for children and adolescents
with regard to foster care, permanency, PREP, and abstinence
education.
Did the program or policy meet the original intent and
objectives? Why or why not?
The PSSF program has met it’s intended objectives over
multiple years. However, the population it serves is constantly
changing and the objectives are fluid based on the legislative
source of funding, so the measure of success is a target that is
constantly moving and difficult to assess.

16. Would you recommend implementing this program or policy in
your place of work? Why or why not?
This program is already implemented in the state of Colorado
and provides funding for valuable resources for children and
adolescents within our state.
I would recommend implementation of this program because it
aims to preserve the structure of families, provide family
support to vulnerable families, provide time-limited
reunification support, provide skills, guidance, and education
for adulthood. Dividing families and removing children from
their biological parents changes the heritage of a family forever.
The PSSF program provides tools to prevent the division of
families whenever possible.
Identify at least two ways that you, as a nurse advocate, could
become involved in evaluating a program or policy after one
year of implementation.
In the role of a nurse advocate we can become involved in
evaluation of a program via multiple different avenues. For
example, nurses can volunteer to participate in the program
planning committee that focuses on evaluation of the program
one year after implementation. By becoming involved at this
level nurses can help to influence discussions regarding needs
for modification to the program in order to help make it more
successful. Nurses can also participate in program evaluation
by contacting legislators who support the program in order to
provide a nursing perspective relative to the program.
Conclusion
The healthcare program evaluated for the purposes of this paper

17. was the Promoting Safe and Stable Families (PSSF). During the
course of research for this paper it was challenging to find all of
the data for completion of the above table. The background,
data, goals, and outcomes were not presented in a
comprehensive way that made evaluation clear and concise. As
research carried on it became apparent why being involved in
program evaluation in person and in real time is imperative to
success of the evaluation process. While evaluation of this
program was challenging it was meaningful in that the impact of
this program over the last 25 years became obvious. The PSSF
program is proof that programs can withstand the test of time as
long as modifications can be made along the way to continue to
best meet the needs of the target population and take into
account the evolving desires of the key stakeholders.
References
Casey Family Programs. (2011). The Promoting Safe and Stable
Families Program: Background and Context. Retrieved from
http://www.casey.org/media/PromotingSafeandS tableFamilies.p
df
Center on Budget and Policy Priorities. (2017). SNAP Helps
Millions of Children. Retrieved from
https://www.cbpp.org/research/food-assistance/snap-helps-
millions-of-children
Colorado Office of Children, Youth, & Families: Division of
Child Welfare. (2018). 2018 Annual Progress and Services
Report: 2015-19 Child and Family Services Plan. Retrieved
from http://co4kids.org/sites/default/files/IM-CW-2017-
0018.pdf
State of California Health and Human Services Agency. (2014).
Promoting Safe and Stable Families Program. Retrieved from
http://www.childsworld.ca.gov/res/OCAP/PSSFFactSheet.pdf
United States Department of Health & Human Services. (2018).
Administration for Children and Families (ACF): Mandatory.
Retrieved from
https://www.hhs.gov/about/budget/fy2018/budget-in-

18. brief/acf/mandatory/index.html#promoting
United States Department of Health & Human Services:
Administration for Children and Families. (2019). FY 2019
Justification of Estimates for Appropriations Committees.
Retrieved from
https://www.acf.hhs.gov/sites/default/files/olab/acf_master_cj_a
cf_final_3_19_0.pdf
United States Health & Human Services: Administration for
Children and Families. (2015). Promoting Safe and Stable
Families. Retrieved from
https://library.childwelfare.gov/cwig/ws/library/docs/capacity/B
lob/105742.pdf?r=1&rpp=10&upp=0&w=+NATIVE%28%27rec
no%3D105742%27%29&m=1
U.S. Department of Health & Human Services: Children’s
Bureau. (2012). Promoting Safe and Stable Families: Title IV-
B, Subpart 2, of the Social Security Act. Retrieved from
https://www.acf.hhs.gov/cb/resource/pssf-title-iv-b-subpart-2-
ssa
1

19. 1
Healthcare Program/Policy Evaluation Analysis Template
Use this document to complete the Module 5 Assessment
Assessing a Healthcare Program/Policy Evaluation
Healthcare Program/Policy Evaluation
Description
How was the success of the program or policy measured?
How many people were reached by the program or policy
selected? How much of an impact was realized with the program
or policy selected?

20. What data was used to conduct the program or policy
evaluation?
What specific information on unintended consequences were
identified?
What stakeholders were identified in the evaluation of the
program or policy? Who would benefit most from the results
and reporting of the program or policy evaluation? Be specific
and provide examples.
Did the program or policy meet the original intent and
objectives? Why or why not?
Would you recommend implementing this program or policy in
your place of work? Why or why not?
Identify at least two ways that you, as a nurse advocate, could
become involved in evaluating a program or policy after one
year of implementation.
General Notes/Comments

21. Healthcare Program/Policy Evaluation Anlysis
Template