The Family First Prevention Services Act in Colorado: An Implementation Guide for County Directors

Teenagers walking together.

Introduction to Colorado’s Implementation Guide


The landmark Family First Prevention Services Act (Family First) was signed into law (P.L. 115-123) as part of the Bipartisan Budget Act on February 9, 2018. Family First includes historic federal Title IV-E finance reforms to help keep children and youth safely with their families and avoid out-of-home placement, emphasizes the importance of children and youth growing up in families, and helps ensure they are placed in the least restrictive, most family-like setting appropriate when foster care is needed. The law creates an expanded entitlement/50% reimbursement stream of federal funds to provide services to keep children and youth safely with their families. When out-of-home placement is needed, Family First allows federal reimbursement for care in family-based settings and certain congregate care programs for children and youth.

Implementation Deadline

October 1, 2021 was the federal implementation deadline for all states to comply with congregate care provisions of the law. The expanded entitlement for prevention services is voluntary and conditional upon approval of a state’s Title IV-E Prevention Program Plan. The Family First Implementation Dashboard reflects Colorado’s progress toward short-term federal compliance goals, medium-term state goals, and long-term system transformation goals. 

Purpose of the implementation guide: The goal of this guide is to support county directors in the implementation of Family First by providing high-level information for directors and balancing detail when appropriate for major system changes. Each section of the guide is formatted to include:

(1) an introduction,

(2) “what county directors need to know,” on the topic and

(3) suggested “action steps” that are designed to be practical and easily digestible.

What County Directors Need to Know
  • Federal Reimbursement for Family First Prevention Services
  • Colorado’s Family First Prevention Candidacy Definition
  • IV-E Candidacy Determinations
  • Prevention Continuum
  • Funding for Prevention
  • Family-Based Residential SUD Facilities
  • Trauma-Informed Care Requirements
  • Fidelity Monitoring and Continuous Quality Improvement
Action Items
  • Ensure child welfare caseworkers and supervisors are prepared for how child welfare practice will look different
  • Learn more about Family First eligible prevention services included in Colorado’s plan that you may want to bring to your community
  • Learn about the residential substance use disorder treatment programs for parents with children
  • Engage in the work to shape Colorado’s prevention services
  • Explore funding opportunities to build a continuum of prevention programs
  • Access more information on understanding financial claiming for prevention services under Family First

What County Directors Need to Know
  • Federal Financing for Congregate Care Placements
  • Specialized Settings
  • Supporting Kin
  • Family-like Placements in the Community
  • Qualified Residential Treatment Programs (QRTPs)
  • HCPF Policy for Residential Providers
  • Psychiatric Residential Treatment Facilities (PRTFs)
  • Family First Transition Funding
  • Funding Options for Residential Treatment
  • Independent Assessment Process for QRTP Placement
Action Items
  • Meet with partners on the local level
  • Prepare your county for the independent assessment process

What County Directors Need to Know
  • Family First Applies to both Dependency and Neglect and Delinquency Court Cases
  • Youth in the Juvenile Justice System are Candidates for Prevention Services
  • Family First Requires That the State Attest That No Policies Will Be Implemented That Will Further Drive Youth Into the Juvenile Justice System
  • GAO Study Requirement
  • QRTP Placements
  • Independent Assessment Process
  • Youth Committed to the Division of Youth Services
  • Juvenile Justice Reform and Family First
  • SB19-108 Summary
  • SB21-071 Summary
  • Assessments
Action Items
  • Utilize the available resources related to Family First and Juvenile Justice Populations
  • View and share the available trainings related to Family First and Juvenile Justice Populations
  • Meet with local partners


Colorado’s Family First Implementation Guide for County Directors is a collaboration between the Colorado Department of Human Services (CDHS) and the Colorado Human Services Directors Association (CHSDA). 

Core Team: Heather Durosko and Lexie Kuznick from CHSDA. Angelina Callis, Yumiko Dougherty and Jon Steinmetz from CDHS.

We gratefully acknowledge the contributions of our colleagues, without whom this resource would not have been possible. Dennis Desparrios, Kendra Dunn, Andrew Gabor, Mary Gerlach, Matt Holtman, Jill Jordan, Aaron Miller, Gretchen Russo, Essie Santillano and Kallen Thornton, from CDHS. John Laukkanen from Health Care Policy and Financing. Nicholas Barela, Jennifer Gribble, Todd Hyman, Jody Kern, Kendra Kleinschmidt, Lanie Meyers-Mireles, Donna Rhode, Deb Ruttenberg, Nan Sundeen, and Nate Winegar from counties. Thank you to all of our partners who provided leadership, subject matter expertise, and guidance on this project.