Family First In Colorado: How We Arrived At The Moment

A timeline of our shared work toward implementation

In February 2018, with the passage of the Family First Prevention Services Act, the federal government reformed child welfare by changing the way states access federal child welfare funding, called Title IV-E or IV-E for short. 

Family First gives states access to federal funding to pay for and expand services that keep kids safe, growing up in their families. Previously, states and Tribes could only tap into this funding if a family was separated. Additionally, Family First created new requirements for the use of IV-E funds for placement in congregate care settings. Read more about these changes.

Colorado embraced Family First because the changes ushered in by the law aligned with changes already underway in our communities. Colorado caseworkers are able to serve approximately 70% of children, youth and families in their homes, keeping them together. Should an out-of-home placement be necessary, young people are more likely to grow up in a family-like setting. In the past decade, the use of congregate care decreased by more than 70%. 

With federal funding coming into alignment with Colorado practice, advocates, county teams, state staff and partners in every community began working to implement Family First by October 1, 2021. What follows are highlights of our shared work toward implementation. 

This work will continue after October 1 as we test in the field what has been in the planning stages until now. Anyone with a question about Family First, should participate in Family First office hours.

Our Shared Work Together 

2018

February 9, 2018

March 2018

  • An advisory committee convenes to create a Road Map that represents understanding, planning and initial implementation of Family First.

May 2018

  • Family First requires an independent third party to conduct an independent assessment to inform whether or not a Qualified Residential Treatment Program (QRTP) provides appropriate services for a child or youth. CDHS begins consulting with the Praed Foundation on the development of an independent assessment process for Colorado. 

August 2018

  • Family First allows states to access IV-E funding for Chafee services for youth up to age 23. To access these funds, Colorado’s extended foster care program needed to extend to youth up to age 21. Although already allowable under Colorado state law, the CDHS Division of Child Welfare (DCW) expanded this practice and opened access to these federal funds by formally changing the age of “child” in the Colorado IV-E plan from 18 to 21.

September 2018

  • Family First requires states to update their foster home rules to meet certain national standards. Colorado holds its first meeting to update these rules, which are later finalized in June 2021.

October 2018

  • CDHS begins the development of a kinship navigator pilot to expand on supports/resources for kinship caregivers and to build evidence. Under the IV-E Waiver, CDHS had already started to collect data on effective services.

December 2018

2019

January 2019

  • Colorado counties convene the Family First Implementation Team (I-Team) composed of state and county staff, providers, advocates and other stakeholders. This group creates work groups and committees focused on changing state rule, policies and practices needed to create the foundation to implement Family First. 
  • New rules increase the number of children and youth (from 4 to 6) a foster family can care for. Stakeholder meetings for these changes began in summer 2018.

March 2019

  • A task group begins reviewing Colorado foster care home licensing requirements to identify what rules need to be adjusted and what need to be created in order to align with national standards in Family First. Between March 2019 and when the rules became final in July 2021, more than 100 individuals provide feedback. 
  • CDHS begins meeting with Boulder County on the county’s use of the CANS assessment. The CANS assessment is later identified as a key component of the independent assessment process for Colorado.

April 2019

  • Family First sets forth specific requirements for prevention plans for families without an open child welfare case and treatment plans for all children and youth in an open case. The I-Team Case Plan work group begins meeting to revise rules for prevention and treatment plans.
  • Judicial staff and best practice court teams receive Family First training during the Colorado Convening on Children and Families, organized in partnership between DCW and the Court Improvement Program.  
  • Initial planning begins to ensure Trails Modernization technical proposals align with the programmatic needs for Family First.

May 2019

  • The Former Foster Youth Steering Committee, established in March 2018 with the passage of HB18-1319, releases its final recommendations, which are later used to inform Colorado’s foster care reentry program and changes required in Family First.
  • HB19-1308 Foster Care Prevention Services is signed into law to align Colorado statute with Family First.

June 2019

  • The CDHS Office of Behavioral Health (OBH) CANS assessment work group, which formed in April 2018, begins coordinating with the I-Team. The CANS assessment is a key component of what will become Colorado’s independent assessment process. 
  • The I-Team recommends OBH manage the Administrative Service Organizations (ASO), the organizations responsible for conducting independent assessments.

July 2019

  • Family First is set as the priority for the Child Welfare Training System. This prioritization, which is still in effect today, includes a review of existing training offers through a Continuous Quality Improvement (CQI) process and the prioritization of new Family First training.
  • OBH contracts with two organizations to serve as ASOs - Beacon Health Options and Signal Behavioral Health. The contracts define the timeline, process, documentation and data requirements for Qualified Individuals, who conduct the independent assessment.

August 2019

  • The Joint Technology Committee provides funding to develop new Family First functionality in Trails.

September 2019

October 2019

  • The Juvenile Justice work group forms to ensure youth who are at risk of or involved with the juvenile justice system and their families have access to prevention services and quality placements if they cannot remain safely at home. 

November 2019

December 2019

  • The federal Family First Transition Act (Transition Act) passes. Colorado will later receive more than $7.7 million to support the implementation of Family First. A work group to inform the use of these funds forms and publishes a funding framework in March 2020. The I-Team further informs the direction of the funding through a survey distributed in April 2020. In 2021, SB21-278 directs 15% of this funding to support QRTP transition. 
2020

January 2020

February 2020

  • County and state finance teams convene to develop a model that would project Colorado's IV-E earnings.
  • Colorado holds feedback sessions to solicit input on the draft Five-Year Prevention Plan.
  • The kinship navigator pilot program launches and data collection begins.
  • CDHS commissions the CANS Paper Review, a review of youth in congregate care to determine whether or not they would qualify for a QRTP. The purpose of this study is to develop a more precise understanding of the needed QRTP capacity.

March 2020

  • The I-Team expands and welcomes two new voting members with lived experience.

April 2020

May 2020

  • New Trails functionality for Family First is released. 
  • DCW and OBH work with residential child care facilities (RCCFs) that intend to become QRTPs as they develop their trauma-informed model need in order to apply to become a QRTP. Hands-on support with trauma-informed models and applications continues indefinitely beyond October 1, 2021. 
  • The I-Team Service Continuum work group completes an assessment of currently available prevention programs that will be eligible for IV-E reimbursement under Family First. Technical reviews of the evidence available begins after an I-Team vote in favor.

July 2020

  • SB20-162 Changes Related To Federal Family First Policy is signed into law. 

August 2020

  • CDHS introduces the Family First Digest email newsletter to keep stakeholders informed.
  • The I-Team Juvenile Justice work group launches a survey to understand what is working well and what prevention services may benefit juvenile-justice-involved youth. The results are shared with the I-Team Prevention work group.
  • Colorado submits a draft Five-Year Prevention Plan to the federal Health and Human Services Department. The plan articulates Colorado’s vision to build upon its ongoing work to provide evidence-based services to keep kids safe and families together. The draft plan includes Colorado’s candidacy definition, which defines who is eligible for in-home services under Family First. 
  • A Family First resource page on CWTS website is launched to centralize training information for professionals.
  • Members of the I-Team complete work on the QTRP bench card. Bench card trainings for different groups of legal professionals occur later in November 2020.

September 2020

  • The I-Team reviews draft therapeutic foster care and draft QRTP rules and provides feedback to DCW. After incorporating this feedback, public comment sessions for these rules are held in October 2020.
  • On the recommendation of the American Indian/Alaskan Native work group, the I-Team recommends the ETHICS training be required for researchers conducting work in regards to Evidence-Based Programs (EBP) in Colorado.

October 2020

  • DCW centralizes Family First foundations training and begins to offer Family First 101 training to any stakeholder group interested in the topic. Later, the American Indian/Alaskan Native workgroup update this training for a Tribal audience.
  • The researchers who developed the CANS tool, part of Colorado’s independent assessment process, present during a child welfare town hall to help counties familiarize themselves with the CANS tool.
  • Family First changed requirements for the federally administered Regional Partnership Grants, which support families impacted by substance abuse. updated information about regional partnership grants. Colorado supported the expansion of Circle of Parents through its Regional Partnership Grant and is working to build evidence to make Circle of Parents eligible for Family First reimbursement.

November 2020

  • The Delivery of Child Welfare Services Task Force’s Statute Review Group expands the scope of its work in order to review rules that may need to be updated to comply with Family First.
  • Web-based Family First training for counties to train their staff is finalized.
  • The CDHS Administrative Review Division (ARD) begins meeting with county stakeholders to develop the QRTP placement review instrument. This work includes developing review instrument instructions as well as drafting rules.

December 2020

  • CDHS issues the Request for Proposals for the first round of Family First transition funding.
  • The I-Team Juvenile Justice work group presents an updated process (and accompanying flowchart) detailing the intersection of child welfare and juvenile justice reforms, as they relate to Family First.

 

2021

January 2021

  • The Colorado Lab at the University of Denver is contracted to develop a short- and long-term strategy for expanding Family First-eligible prevention services in Colorado to meet the needs of Colorado’s children, youth and families while maximizing federal drawdowns for evidence-based services.
  • CDHS hosts a series of placement continuum learning collaboratives to identify strategies to build out the placement continuum and ensure all children and youth are in a family-like setting or QRTP. 
  • The I-Team American Indian/Alaskan Native work group completes a search and review of programs that are either culturally responsive or adapted in order to be culturally responsive and may eventually qualify for inclusion on the Clearinghouse. This analysis and recommendations are presented to the I-Team.

February 2021

  • The county independent assessment training and resource toolkit is created. The toolkit continues to grow and expand for additional audiences.
  • The I-Team’s Constituent Engagement Group makes formal recommendations to develop and embed continuous family feedback loops into new practices.
  • The I-Team QRTP work group begins working on new rules for carve-out populations (youth age 18-21, survivors of sex trafficking, and pregnant or parenting children and youth) who can be placed in a specialized group setting (i.e. a congregate-care placement other than QRTP) that will be eligible for IV-E reimbursement. 

March 2021

  • Training and workforce development begins for Qualified Individuals, the independent third parties who will conduct the independent assessment.
  • The first county cohort to use the independent assessment process begins training and implementation. 
  • The Division of Youth Services (DYS) begins to pilot the independent assessment process in the northeast region.
  • The Juvenile Justice work group completes its analysis of current assessments utilized for juvenile-justice-involved youth to determine how the independent assessment can be integrated without duplicating efforts. This work began in December 2020.

April 2021

  • A subcommittee of I-Team’s Services Continuum workgroup forms to develop standards to comply with Family First’s requirement for trauma-informed prevention services. 
  • The first round of transition funding grants is awarded to support promising prevention programs.
  • Therapeutic foster care rules take effect with training for counties and CPAs interested in developing this type of program scheduled for October 2021.
  • Family First training is provided to county, judicial and state staff during the three-day Convening on Children, Youth and Families. Watch the plenary.
  • Following engagement with various work groups, the draft rules for the ARD QRTP placement review are presented to the I-Team.

May 2021

  • Weld and Douglas counties become the first two Colorado counties to implement the independent assessment process.
  • The Prevention Task Group launches. Among its many priorities, the group will build the prevention services infrastructure to expand services and maximize federal funding available under Family First.
  • The Family First Dashboard is introduced as a public accountability and transparency tool.
  • Stakeholders convene to write rules and inform practice relating to county responsibilities when placing a child or youth in a QRTP.

June 2021

  • A second RFP is released for Family First Transition Funding.
  • CDHS hosts a provider town hall to convene congregate care providers, counties and other stakeholders to discuss the transition to QRTPs required by Family First. 
  • The Colorado Lab hosts a series of informational sessions on the models recommended for the mental health services array as part of Family First capacity-building efforts.
  • HB21-1094 reformed extended foster care to create a formal period in which a young person decides to enter the Foster Youth in Transition Program (i.e. extended foster care) or emancipate and creates a court oversight to ensure young adults are aware of their rights and engaged in a thoughtful process. 
  • HB21-1248 is signed into law. The law renames the Colorado Children's Trust Fund the Colorado Child Abuse Prevention Trust Fund. Preventions fund earned through Family First will be directed to this fund.

July 2021

  • New reimbursement rates for foster care go into effect. The Foster Care work group, a subgroup of the Child Welfare Policy Advisory Committee, informed the new higher, tiered rate structure. 
  • DCW releases its initial analysis of the number of QRTP beds that will be available on October 1. As licensing specialists continue their work to support providers, this analysis is updated and shared online.
  • National Model Foster Care Model Standards go into effect. These rule changes align Colorado rule with federal recommended licensing standards.
  • The Colorado Lab publishes its report to develop a short- and long-term strategy for expanding Family First-eligible prevention
  • The State Human Services board approves new rules for QRTPs.  
  • Alternative care rules are approved making it easier for foster parents to rely on their normal social connections, like parents or neighbors, to watch children and youth in foster care for short periods of time just as those same social connections would watch a parent’s biological child.
  • DCW kicks off cultural competence training development specific to Family First. This is in response to feedback from the I-Team American Indian/Alaskan Native work group. The first training is scheduled to be delivered in October 2021.

August 2021

  • Clarified processes to ensure federal and state funding is used effectively and Medicaid is leveraged appropriately. A desk aid is released the following month.
  • Colorado counties complete the independent assessment training process with each county cohort participating in bi-monthly check-in meetings scheduled through at least the end of 2021.
  • CDHS issues an Operation Memo to define the Continuous Quality Improvement process for the independent assessment process prior to rule writing.
  • CDHS releases an updated fiscal analysis projecting the State of Colorado will earn $2.1 million in the first two years of Family First.
  • DYS begins work on the QRTP length-of-stay waiver. 
  • CHSDA and CDHS release The Family First Prevention Services Act in Colorado: An Implementation Guide for County Directors.
  • Two additional RFPs for Family First Transition Funding are released.
  • CHSDA and CDHS host a four-part series on financial claiming under Family First.

September 2021

  • Integration of independent assessment process into DYS assessment process is proposed. 
  • All four DYS regions complete independent assessment process training.
  • DCW issues three Operation Memos to formalize final details and requirements prior to the federal government’s implementation deadline. Guidelines include new rules for special carve-out populations, IV-E reimbursement, Trails, QRTPs and more. 
  • CDHS releases videos created to help youth and families understand the independent assessment process. 
  • Following feedback sessions, the Five-Year Family First Prevention Services Plan is submitted to the federal government for final approval.

October 2021

  • CDHS begins hosting weekly office hours open to anyone with a question about Family First. 
  • With implementation transitioning to established work groups and committees, the I-Team sunsets. 
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