
Throughout my career, including as a pediatrician directly caring for children, and as a human services policy leader at the U.S. Department of Health and Human Services, I have repeatedly seen first-hand that investing in prevention will always be worth it. Over the past four years, the Administration for Children and Families (“ACF”) has prioritized the development and implementation of innovative policies and approaches that reshape our approach to prevention in ACF programs. While ACF will always work hard and invest in serving children and families in crisis, our focus over the last four years has also been to support families before a crisis hits or persists.
First and foremost, we sought to strengthen supports for parents to keep children safely at home and out of foster care, including through the Family First Prevention Services Act (“Family First”). Enacted with broad bipartisan support, Family First seeks to incentivize states to invest more in prevention by opening a new stream of federal child welfare funding for parenting classes, substance use programs, and mental health services, all with the goal of supporting parents and preventing the need for children to enter foster care. When we entered office, only nine jurisdictions had an approved prevention plan under Family First, which is required to tap into this optional funding source. At the time of this writing, 48 jurisdictions now have an approved plan, meaning we more than quadrupled the number of places eligible for these prevention dollars. In 2022, only $64 million of dollars had gone out. As of today, over $340 million dollars have gone to communities across America to help parents during their time of need and keep their kids safely with them.
We also enacted regulatory changes to help keep children with their families. We allowed child welfare agencies to use federal funds to help cover the costs of an attorney for a parent or caregiver in civil legal proceedings when doing so would support a child’s needs. For example, federal dollars could now be used to help to secure stable housing or public benefits, or obtain an order of protection against an abuser, all in service of helping prevent the unnecessary removal of a child from the home. This goal of keeping children with their families also looked beyond their parents. More than two million children in America are being raised primarily by relatives or kin. When we talked to kin caregivers, what we heard was that the licensing standards were unnecessarily burdensome and did not sufficiently take into account the fact that they were related to the child. Some of the most difficult stories we heard were of family members who wanted to care for a child, but either they could not afford the additional costs or the non-safety standards set by the state were too onerous - for example, an aunt had a spare bed for the child in a shared room with a cousin, but the state required the child to have their own room. That feedback led us to provide jurisdictions with the option to simplify licensing standards for kin caregivers, without sacrificing safety, so that relatives could more easily become licensed and become eligible for full financial support from the state child welfare system. By supporting the people that parents trust and turn to in their time of need, we are placing kids in their own relatives’ homes where research shows they are more likely to have better outcomes. To date, 13 jurisdictions have adopted separate licensing standards for kin caregivers.
Economic security has also stood out as a key element in the prevention framework. For many parents, preventing a crisis from occurring or persisting by addressing immediate needs can alleviate substantial pressure and lessen the risk of being charged with neglect. However, even under Family First, which has the explicit goal of preventing entry into foster care, the primary federal foster care funding stream may not be used for economic support to help economically-insecure families. We therefore also looked at other programs under ACF’s purview and integrated them into our prevention strategy. We helped families pay the utility bills, ultimately giving out $22.5 billion over the course of the Administration in utility assistance. We also created an online eligibility tool so families could more easily determine if they qualified for this utility bill assistance. We launched a water bill assistance program that helped over a million and a half families pay their water bills until the program expired in 2024. We started a brand-new diaper program, helping parents and caregivers cross that item off their monthly expenses. We required states to limit co-payments for families receiving child care subsidies, which will save 100,000 families $200 a month, on average. We issued a final rule stating that states can use federal child support dollars to help noncustodial parents find and keep jobs. Most recently, we reiterated that the Temporary Assistance for Needy Families (TANF) program can be used to provide direct financial assistance to families when they fall on hard times. All of these efforts are funded outside of child welfare and play a key role in helping to support families and prevent child welfare involvement.
We also took a similar prevention-focused approach across several other ACF programs. We created a new prevention grant that allowed federal dollars to be used for direct cash assistance for young people at risk of homelessness or running away. We conducted parent trainings on behavioral health so parents had more tools to prevent, recognize, and address a crisis. We launched the Human Trafficking Youth Prevention Education program, which trained more than 22,000 educators and 87,000 students on human trafficking. We strengthened our role in the whole-of-government response to protecting unaccompanied children by deepening interagency and stakeholder partnerships to help children at risk of exploitation access protective services. We provided unaccompanied children who had previously been in the custody of the Office of Refugee Resettlement with legal services and social supports to prevent exploitation. We worked with communities before they experienced a natural disaster to build resilience and strong foundations. The list goes on.
While we focused on engaging families before they reached a crisis, we know we still have a lot more work to do to increase child and family safety and well-being, prevent child fatalities, and build economic stability for all families. I am hopeful that our country will continue to take a prevention-focused approach and invest upfront in families and children.
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