A June 2018 webinar sponsored by the Annie E. Casey Foundation and the William T. Grant Foundation — now available via recording — provides an overview of available funding streams for implementing and sustaining evidence-based programs in child welfare, with a special emphasis on the Family First Prevention Services Act.

1. leading with
evidence
webinar
Funding and Sustaining Evidence-Based
Programs in Child Welfare Systems

2. The Leading With Evidence Webinar Series
1

3. Today’s Presenters
2
Suzanne
Barnard,
The Annie E.
Casey
Foundation
(Host and
moderator)
Margaret
Flynn-Khan,
Mainspring
Consulting
Kristin
O’Connor,
North Carolina
Division of
Social
Services

4. 3
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Communicating During the Webinar
This webinar is being recorded! We’ll share the
recording with those registered and at
www.aecf.org/webinar.

5. 4
What You’ll Learn Today
• Implications of the Family First Prevention
Services Act
• Highlights from research on state and local child
welfare systems that have funded and sustained
evidence-based programs
• State leader perspective: North Carolina
experience

6. FUNDING EVIDENCE-BASED PROGRAMS
AND THE FAMILY FIRST ACT
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Margaret Flynn-Khan

7. 6
Objectives
Participants will understand
• Key prevention provisions of the Family First
Prevention Services Act and opportunities to
support evidence-based programs
• Lessons learned by state and local child welfare
leaders in implementing and sustaining evidence-
based programs

8. Limited Support for Prevention in Child Welfare
Funding Streams
Title IV-E Foster Care
Title IV B, Parts 1 and 2
CAPTA State Grants
Community Based Child
Abuse Prevention
$5,500,000,000
$614,000,000
$85,000,000
$39,700,000
Federal FY 18 Funding Levels
Has funded
prevention and
preservation
Has funded
foster care
placements and
administration
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9. Family First Prevention Services Act
within Bipartisan Budget Act of 2018, (Public Law 115-123)
• Focused on Keeping Children in Families
– Allows Title IV-E Funds to support prevention and preservation
services
– Places limits on federal payments for congregate care
placements, emphasizing high-quality care
o Qualified residential treatment program (QRTP)
o Home for parenting and pregnant teens
o Independent living setting for youth 18+
o Residential care for sex trafficking victims
o Residential family-based substance abuse treatment facility
• Begins October 2019; state can ask for delay (up to 2 years)
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10. Family First:
Title IV-E Support for Prevention Services
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WHO
Candidates for foster care
Their parents and kin caregivers
Pregnant and parenting youth in
care
WHAT SERVICES
Mental health and substance
abuse prevention and treatment
In-home parent education, parent
training and counseling
Trauma-Informed and Federal Payment Limited to 12 Months

11. Family First: Prevention Services Must Be
Evidence Based
• Promising
– Study with “some form of control” group (a placebo group,
a waitlist or a group of untreated people). (CEBC 3)
• Supported
– Random-controlled trial or a “rigorous” quasi-experimental
design carried out in a usual care or practice setting.
Sustained effects for six months. (CEBC 2)
• Well-Supported
– Two random-controlled trials and one documents
sustained effect for at least one year. (CEBC 1)
• By October 2018 - HHS will provide guidance to states on
applying criteria and list of programs and services that meet criteria
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12. Family First:
Title IV-E Support for Prevention
• Administrative Services and Training: 50% federal
match
– Program planning, coordination, contracting,
continuous quality improvement and data collection
and reporting
– Training for child welfare staff and staff of state-
licensed or approved child welfare agencies
o Topics include: how to determine who is eligible,
how to identify and provide appropriate services
and programs, how to oversee and evaluate the
ongoing appropriateness of the services and
programs
11

13. Family First:
Key Funding Provisions
• Prevention Services and Programs matched
without regard to income eligibility
– FY 2020 – FY 2026 at 50%
– Beginning in 2027 - based on FMAP
• At least 50% of federal payment for “well-
supported” programs
• Maintenance of Effort: Same level of “state
foster care prevention expenditures” as FY
14 (from Title IV-B, TANF, SSBG and state or
local)
• Timeline: State option to begin claiming
October 2019 (provided state does not ask for
delay on placement requirements)
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14. Brief: How States Are Funding
Effective Implementation
• Summarizes lessons learned
from child welfare system
leaders who have
implemented and sustained
evidence-based prevention
services
13

15. Jurisdictions Interviewed
WA
OR
CA
MT
ID
NV
AZ
UT
WY
CO
NM
TX
OK
KS
NE
SD
ND
MN
IA
MO
AR
LA
MS
AL
GA
FL
SC
TN
NC
IL
WI
MI
OH
IN
KY
WV VA
PA
NY
ME
VT
NH
NJ
DE
MD
Washington D.C.
MA
CT
RI
• New York City
• Allegheny County, PA
• Catawba County, NC
• Colorado
• Connecticut
• New Jersey
• North Carolina
• Ohio
• Washington 14

16. Stage Agency Staffing Needs Purchase/Contract
Exploration  Collect, analyze, review data
 Research and identify evidence-
based programs
 Engage players and gain buy-in
 Technical assistance to guide
and facilitate program
selection
Installation
 Develop RFP/contract process
 Establish structures, processes and
work supports
 Attend training
 Program materials and
training
 Contracted provider time to
attend training
Initial and Full
Implementation
 Coordination and supervision of
implementation
 Alignment of agency policy and
practice
 Data collection and analysis
 Fidelity monitoring and quality
improvement processes
 Staffing and implementation
costs
 Licensing
 Training due to staff turnover
 Fidelity monitoring and
quality improvement
 Data and evaluation
Key Costs to Consider
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17. What EBPs Are Agencies Using?
• Triple P
• Safe Care
• Strengthening Families (Blueprints Promising)
Prevention
• Functional Family Therapy
• Multisystemic Therapy
Behavior
Management
• Child-Parent Psychotherapy (CPP)
• Parent-Child Interaction Therapy (PCIT)
• Trauma-Focused Cognitive-Behavioral Therapy
Therapeutic
Services
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• Meets Well Supported Standard (CEBC 1)
• Meets Supported Standard (CEBC 2)

18. Funding Streams Supporting Programs
• Federal and foundation grants for start-up
• State and local child welfare funds
• Title IV-E Waivers
• Title IV-B, Parts 1 and 2
• Medicaid
• Other federal:
– Temporary Assistance for Needy Families (TANF)
– Community-Based Child Abuse Prevention (CBCAP)
– Title V, Maternal and Child Health Block Grant and Home
Visiting
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19. 18
Key
Strategies
to Inform
State
Efforts to
Develop
Evidence-
Based
Prevention
Services

20. Information Resources
• Family First
– ACF, Children’s Bureau Information Memorandum:
https://www.acf.hhs.gov/cb/resource/im1802
• Evidence-Based Program Databases
– California Evidence-Based Clearinghouse for Child Welfare:
www.cebc4cw.org
– Blueprints for Health Youth Development Database:
www.blueprintsprograms.com
• Funding Effective Implementation of Evidence-Based
Programs in Child Welfare
– http://www.aecf.org/resources/funding-effective-implementation-
of-evidence-based-programs-in-child/
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21. STATE HIGHLIGHT:
NORTH CAROLINA
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Kristin O’Connor

22. 21
North Carolina’s Path
2004
• Federal CBCAP Efficiency Measure
2005
• NC Institute of Medicine: Task Force on Child Abuse
Prevention
2005
• Alliance for Evidence-Based Family Strengthening
Programs
2007+
• RFA and Funding Priority Refinements
2018
• State and Local Implementation Capacity Building

23. Family
Support
Fund
Community
Response
Series
CPS In-
Home
Services
Out-of-
Home
Placement
Permanency
Evidence-
based
programs
• Incredible Years
Preschool +
School Age
• Circle of Parents
• Strengthening
Families 6-11
• Triple P
• EBP varies
based on
family needs
• Home-builders
(IFPS)
• Child
FIRST
• Attachment and
Bio-behavioral
Catchup
• Triple P
• TF-CBT
• SPARCS
• PCIT
• CPP
• Triple P
• Resource
Parent
Curriculum
Funding
source
• CBCAP
• IVB-2 Family
Support
• Children’s Trust
• State
• IVB-2 Family
Support
• IVB-2 Family
Preservation
• State
Appropriation
• Medicaid
• State
Appropriation
• Medicaid
• IVB-2 Adoption
Promotion
• TANF
• State
Appropriation
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Models and Financing Along
the Child Welfare Continuum
LEAST INTENSIVE MOST INTENSIVE

24. Family
Support
Fund
Community
Response
Series
CPS In-
Home
Services
Out-of-
Home
Placement
Permanency
Evidence-
based
programs
• Incredible Years
Preschool +
School Age
• Circle of Parents
• Strengthening
Families 6-11
• Triple P
• EBP varies
based on
family needs
• Home-builders
(IFPS)
• Child
FIRST
• Attachment and
Bio-behavioral
Catchup
• Triple P
• TF-CBT
• SPARCS
• PCIT
• CPP
• Triple P
• Resource
Parent
Curriculum
Funding
source
• CBCAP
• IVB-2 Family
Support
• Children’s Trust
• State
• IVB-2 Family
Support
• IVB-2 Family
Preservation
• State
Appropriation
• Medicaid
• State
Appropriation
• Medicaid
• IVB-2 Adoption
Promotion
• TANF
• State
Appropriation
23
Models and Financing Along
the Child Welfare Continuum
LEAST INTENSIVE MOST INTENSIVE

25. Cycle 3
2016-2018
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2007-2018: RFA Refinement
Cycle 2
2013-2015
Cycle 1
2007-2012
Increase in # EBP/EI Programs
CBCAP Efficiency Measure
80% EBP
20% EI
80% 4 Models/State Level IS
20% EBP/No State Level IS
Getting to Outcomes:
State-Level Partnership + Infrastructure Development
Focus on Implementation

26. 25
Getting to Outcomes:
State-Level Partnership + Implementation Focus
• Support
Establish shared vision
Interest > position
Prioritize implementation
supports and evaluation
Support common
intermediate outcomes
Collaborative
funding decisions

27. 26
Considerations for Purveyors/Model Developers
Clear theory of change
and logic model
Evaluation requirements
and how they are funded
Clarity about
adaptations needed
Easily teachable
core components,
manualization
and supportive TA
Replications over # of
trials to ensure validity
of intervention
Alignment with state
mandates/conditions
placed on funding by
legislators/rule makers
What are training and
implementation costs
and who bears them?
Implementation supports
for model and for how long
Meeting agency goals
for populations
to be served

28. 27
Considerations for Providers and Child Welfare Leaders
Time for exploration
and installation phases
Sustainability plans to
ensure service continuity
Supplemental services
aligned in support of
EBP (case management,
screenings, etc.)
Provider competencies
required/desired to
apply EBP
Evaluation of outcomes
Training and ongoing
workforce development
available to
support model
Plans to ensure
compliance with
funding/legislative/
accountability
requirements
Fit with community
vision for serving children
and families
Capabilities to serve
desired population

29. 28
North Carolina’s Key Lessons
• Need for strategic road map: vision and outcomes
• Lead with evidence of the EBP and evidence of
implementation
• Responsibility to invest in both direct services and
implementation supports
• Public/private financing and programmatic partnerships
• Trust = transparency + time + surrender of agency
agenda
• Importance of organization and leadership drivers

30. Please use the Q&A function on your
screen to submit questions.
A recording of this webinar will be sent to
those who registered and posted at
www.aecf.org/webinar.
Questions?
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31. 30
Kinship Navigator Federal Funding Opportunity
A Family First Q & A:
Apply for Federal Kinship Funds
by July 20
Read the Q&A at
http://www.aecf.org/blog/a-family-first-q-a-apply-for-federal-kinship-funds-
by-july-20/

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Next in Our Webinar Series
Assessing Readiness for Implementation:
Introducing the Hexagon Tool
1 p.m. — 2 p.m. ET
Tuesday, September 18, 2018
Register at https://bit.ly/2MA2J0J
For additional information after this webinar:
Kate Shatzkin, kshatzkin@aecf.org
For supplemental materials and more information about research
and evidence in public systems:
www.aecf.org and http://wtgrantfoundation.org/