Family First Implementation FAQs

Children, youth, and families in Colorado deserve access to resources that could provide evidence-based services to keep families together and improve their outcomes.

Family First provides an opportunity to make substantial improvements in the outcomes of children, youth and families in the child welfare system. By providing a pathway for the child welfare system families stay together, Family First helps ensure that children/youth are not unnecessarily separated from parents who could provide safe and loving care if given access to needed mental health services, substance abuse treatment or improved parenting skills.

Such improvements, as Family First seeks to create, require shifts in long-held mindsets, a new vision of serving children, youth and families, and a commitment to a different way of working with communities and the broader child welfare system. Family First focuses on ensuring that when children/youth must be removed from their families, they are with family/kin or in family-foster homes. When children/youth need a higher level of care as determined by the statewide assessment tool, they will have the supports of a time-limited, high- quality, trauma-informed QRTP setting.

While Family First is a federal law, and all states must comply, implementing Family First is an opportunity for Colorado to lead, innovate and further Colorado’s vision and mission to support children, youth and families. 

DCW, as the IV-E agency, is responsible for overseeing and monitoring the five-year Family First Prevention Plan in Colorado. Services are administered by program providers, who are overseen by program intermediaries contracted with DCW. The Child Welfare Prevention Task Group was created to continue the work of the Services Array Subcommittee that was part of initial Family First planning efforts. The Child Welfare Prevention Task Group continues building statewide and county infrastructure to operationalize and evolve Colorado’s Family First Prevention Services Plan, and is overseen by the Child Welfare Sub-Policy Advisory Committee. The Colorado Implementation Science Unit (CISU), housed within the Office of Children, Youth and Families at the Colorado Department of Human Services (CDHS), is supporting the scaling of Family First prevention services – evidence-based services/programs that prevent foster care placements by providing enhanced support to children and families – across the State of Colorado.

In order to access Title IV-E funds for prevention services available through Family First, each state must submit a federal Prevention Program Plan (Plan) to the Children’s Bureau for review and approval. Colorado’s five-year Plan was approved in September 2022.

CDHS is working to expand the prevention services continuum, increase the utilization of prevention services, and broadening the scope of Family First candidates. In close partnership with the CWPTG, CISU, and the CO Lab, CDHS has been working to explore new strategies and opportunities to scale and/or replicate evidence-based services across the state. CISU also provides communities with dedicated implementation support, no matter where they are at in their Family First implementation stage, to ensure that families have access to services that meet their needs, and champion additional opportunities to leverage Family First in their service array. 

The Family First Prevention Services Act (Family First) creates an expanded entitlement/50% reimbursement 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.

A child is considered to be a candidate for prevention when:

• The child is designated as being at “serious risk” of out-of home placement;
• There is a prevention/treatment plan in place for the child and/or their family;
• The child and/or their family is receiving an evidence-based service; and 
• The child is residing in a “family like” setting.

Note:  The Family First Transition Act temporarily suspends the requirement that at least 50% of title IV-E prevention services expenditures be for “well-supported” practice for two fiscals years, then phases it back in as follows: 

In FY 2020 and FY 2021 states are not required to meet the 50 percent “well-supported” expenditures requirement (section 602(b)(1) of the Transition Act).

In FY 2022 and FY 2023, at least 50 percent of the amounts expended by the state for a FY for the title IV-E prevention program must be for services that meet the “supported” and/or “well-supported” practice criteria” (section 602(b)(2) of the Transition Act).

Beginning with FY 2024 and for all FYs going forward, states must meet the 50 percent “well-supported” expenditures requirement as described in section 474(a)(6)(A)(ii) of the Act.

Supported and well-supported services in Colorado’s prevention plan should be paid for using the Core Services Program allocation, Child Welfare Services Block, or State General Fund.

Guidelines will be developed in conjunction with the completion of Trails Modernization. Once Trails Modernization user stories are implemented for prevention services, and legacy Trails migrates to modernized Trails for both Core Services and Child Welfare Services Block, documentation can be established for best practices and communicated to Trails users. 

Four different circumstances trigger completion of the Candidacy form in Trails:

• Creating a treatment/prevention plan (FSP3A) and adding at least one objective and candidacy screen has not been completed;
• Doing a 90-day review (FSP5A) (unless all of the active children/youth in the case are in Out-of-Home (OOH));
• Opening a removal; or
• Closing a removal (except in situations where the removal closure reason is:
  • Adoption, Emancipation, Death, Transfer to DYC, or Runaway)

The Trails user stories set up prevention candidacy as an entitlement just like IV-E eligibility so that the fiscal benefits may be realized more easily.

26-5-101 C.R.S. defines Child Welfare Services and includes “Core Services,” “Early Intervention and Prevention,” as well as a number of other services. Prevention services candidacy is determined by meeting the criteria in the definition PLUS the existence of an evidence-based service. When both of these things are true, then that child or youth is a Prevention Candidate and Colorado is able to draw-down administrative costs and 50% federal reimbursement for the service costs. 

IV-E prevention candidacy and traditional IV-E candidacy are separate determinations. 

Administrative costs can be claimed for two different types of “candidacy” once Family First is implemented:

Traditional IV-E reimbursement for administrative activities related to pursuing the removal, or providing reasonable efforts to prevent the removal, of a candidate for foster care (conditioned on a child being eligible for Title IV-E foster care). This allowable use of Title IV-E Admin will continue to be an allowable use unchanged by Family First, and 

New IV-E reimbursement for administrative and training costs related to preventing entry into foster care for ANY child who is a “candidate for foster care” under the state’s candidacy definition 

Trails job aids and cheat sheets can be found on the Child Welfare Training System website.

Colorado will receive partial federal reimbursement under Family First for a limited set of approved evidence-based prevention programs and services included in Colorado’s Family First plan. The new federal reimbursement that Colorado receives for these programs will be claimed by CDHS, as the Title IV-E agency. Federal reimbursement for Family First prevention services will then be transferred to the Colorado Child Abuse Prevention Trust Fund. Funding will be awarded via ongoing RFPs to strategically expand evidence-based prevention services over time and build programs in areas of Colorado where they don’t already exist.

CDHS engaged the Colorado Evaluation and Action Lab at the University of Denver to develop a short and long-term strategy for expanding Family First-eligible prevention services in Colorado. Download the report.

Colorado’s federal partners have clarified that program expenditures under Medicaid for well-supported programs will not count toward the 50% requirement in section 474(a)(6)(B)(ii). Only amounts expended under the title IV-E prevention services program in section 474(a)(6)(A)(i) for the provision of title IV-E prevention services or programs that are provided in accordance with well-supported practices count toward the 50% requirement in section 474(a)(6)(A)(ii).