Colorado Family First Implementation Dashboard

The Family First Prevention Services Act (Family First) is the most significant change to child welfare in decades. For the first time, federal funding can be accessed for prevention services that keep kids safe, growing up with their families. If staying home safely is not possible, Family First encourages care in a family-like setting or, if necessary for a short time period, care in a congregate setting designed to meet specialized treatment needs.

Colorado must comply with specific federal Family First requirements by October 2021. Additionally, Family First is one piece of a broader Colorado vision to evolve the child welfare system to serve children, youth and families together.

 

Implementation Principles

Implementation will occur alongside other system reforms and our ongoing work with children, youth and families.

Successful implementation will require strong and sustained partnerships among multiple stakeholders.

Implementation is a long-term, iterative process. There is no flip-the-switch moment when implementation is complete.

Through implementation of Family First, Colorado strives to improve policy, practice and quality of services in order to support community, culture, diversity, equity and access for all Coloradans across the state. See the full commitment statement here.

FAMILY FIRST IMPLEMENTATION DASHBOARD

The Family First Implementation Dashboard reflects the state's priorities related to Family First and creates transparency with external stakeholders. The Dashboard is dynamic and will be updated regularly to reflect our progress toward short, medium and long-term goals.

SHORT TERM: FEDERAL COMPLIANCE

To comply with Federal Law, the State of Colorado must have the following in place:

 
Qualified Residential Treatment Program (QRTP) rules
QRTP rules have been drafted and an application process has been developed to support this new Family First-eligible licensing designation. Final QRTP rules (7.705) went to the State Board of Human Services in July 2021, and will be effective October 1, 2021.
Links: QRTP fact sheet, QRTP Resource Page.
 
Trauma-Informed Care Model Standards for QRTPs
CDHS-Office of Behavioral Health developed Colorado’s trauma-informed care model for QRTPs and will approve each facility’s plan as part of the QRTP application process.
LinksQRTP resource page, QRTP Trauma-Informed Care Model
 
Independent Assessor process, including selection of a validated functional assessment tool and Qualified Individuals
Colorado has designed an independent assessor process to determine whether QRTP-level care is appropriate for individual children and youth.
Links: Independent Assessment process and fact sheetOperation memo with new state rule
 
 
Revised rules to meet National Model Foster Family Home Licensing Standards
Rules have gone into effect as of June 1, 2021. Confirming guidance from the federal government regarding immunization and any needed changes to Colorado rule. 
Link: Revised rule.
 
Extended eligibility for foster care up to 21 years of age
Colorado has added extended foster care up to age 21 in its Title IV-E plan since early 2018. This change allows Colorado to access Chafee expansion up to age 23. Colorado is now in the process of ensuring implementation is consistent and supported throughout the state.
 

MEDIUM TERM: STATE-LEVEL GOALS

Colorado’s vision is to leverage Family First for sustainable system reform, not just compliance:

Opt-In to Prevention Services:
 
Federally approved state prevention services plan
An approved plan will allow Colorado to begin drawing down federal reimbursement for eligible services. Federal feedback was received on Colorado’s first draft plan, and the next version is in development.
Status: Final plan, submitted on September 30, 2021, is awaiting final approval from the federal government.
 

State-level infrastructure to meet federal requirements and claim reimbursement
Fiscal and data systems are in place to track and claim federal reimbursement. Family First fiscal claiming group has completed its work.
Update: Colorado is in the process of designing and developing a statewide CQI Platform. 
Link: Claiming under Family First training series

 
Prevention services expansion study and strategy
Colorado is in the process of using a data-informed process to develop a short, medium and long-term strategy for prevention services expansion statewide. 
Video: Mental health service array information sessions
Link: Strategy for the Evidence-Based Aspects of the Family First Service Continuum
Expand Family First-Eligible Placement Options:
 

IMD Issue Resolution and Policy Implementation (HCPF)
The federal law governing Institutions for Mental Diseases (IMD) was considered a major barrier to implementation. The Colorado Department of Health Care Policy and Financing (HCPF) has developed additional clarification and draft policy to minimize impact to Colorado’s placement continuum. Rule changes and implementation infrastructure are in development
Link: QRTP/IMD information and fact sheet.
Update: Rule has passed Medical Services Board (MSB) and awaiting CMS approval. 

 

Guidance/rule for serving specialized populations
Eligibility criteria for youth victims of sex-trafficking and for pregnant and parenting youth to be served in residential care settings outside of QRTPs have been developed. Parameters for programs specializing in the care of youth victims of sex-trafficking have also been developed. Any parameters that are going into rule will go to the State Board of Human Services in July 2021.
Link: Download draft rules
Update: Rules drafted and pending approval at State Human Services Board by February 2022. Operation memo with rule and guidance to be issued before October 1, 2021.

 

Placement continuum strategy
CDHS has developed a set of key strategies, based on stakeholder input, for rightsizing and refining the placement continuum.

Link: Key Themes and Next Steps summary

 

Independent assessment process for counties
Dark blue: Prepared for independent assessment
Link: Independent Assessment county cohorts.

Minimum QRTP capacity of 240 beds
171 QRTP beds available to date.
Link: Provider transition analysis updated on May 1, 2022. An estimated 240 estimated capacity when the transition is complete.
 
Family First Transition Funding
$1,590,705 in strategic investment to ensure statewide readiness.

LONG TERM: SYSTEM TRANSFORMATION

Implementation is a long-term, iterative process 

Family First will be leveraged as one of many strategies to achieve the state’s long-term goals:

Moving from a reactive child protection system to a proactive child and family well-being system 

Prioritizing and incentivizing expansion of community-based prevention-focused services and dramatically reducing the need for out of home care   

Building a robust continuum of care that is responsive to the needs of children, youth and families  

If not you, then who?
Colorado Child Abuse and Neglect Hotline
Available 24 hours a day, every day. Don't hesitate to call and get help. 
Anyone witnessing a child in a life-threatening situation should call 911 immediately.