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Family First: Exciting Chapter Advocacy Opportunities Around Landmark Child Welfare Reform

Explore the current state of child welfare policy, the impact of the opioid crisis, and how the Family First Prevention Services Act is revolutionizing child welfare. Learn how AAP chapters played a critical role in enacting these reforms and how they can help implement the law.

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Family First: Exciting Chapter Advocacy Opportunities Around Landmark Child Welfare Reform

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  1. Family First:Exciting Chapter Advocacy Opportunities Around Landmark Child Welfare Reform Zach Laris, MPH Director, Federal Advocacy & Child Welfare Policy American Academy of Pediatrics

  2. Overview • Current State of Affairs in Child Welfare Policy • The Opioid Crisis Imperative • Family First- An AAP-Championed Reform • How Chapters Helped Enact Reform • How Chapters Can Help Implement the Law

  3. Relevance for Chapters • AAP Chapters played a major role in enacting these reforms • State action necessary to create benefit for children and families • Somehow in 2018, the “E” word…

  4. The 411 on Title IV • Social Security Act child welfare programs • IV-B- Family preservation and CW systems. Limited and appropriated. • IV-E- Foster care maintenance. Open ended. • Critical programs, unbalanced incentives.

  5. Child Welfare by the Numbers • FY 2017- 442,995 children in foster care • Peaked at 567,000 in 1999 • Declined to a low of 396,966 in 2012 • Infants are nearly a fifth of entries to the system • FY 2016- 36 percent of removals were due at least in part to parental substance use • We know what works, we just haven’t been funding it.

  6. The Opioid Crisis and Child Welfare • Sustained policymaker attention • Bipartisan consensus on treatment focus • But what about children and families? • Growing understanding of the science of addiction and attachment

  7. But Wait, There’s Hope! Today’s Tale: • A new law promises a HUGE difference • How AAP members and chapters made it possible • What AAP chapters can do going forward to support implementation

  8. Family First Prevention Services Act • Bipartisan, comprehensive child welfare reform legislation. • Enacted in Bipartisan Budget Act of 2018 • Extensive AAP involvement in development and advocacy.

  9. Underlying Approach • Improving wellbeing of children by reducing unnecessary foster care • Address flawed financing incentives • 7-1 spending mismatch. • Right-sizing congregate care • Children fare best in families- how do we make policy support that?

  10. Family First Prevention Policies • Focus: Prevent foster care when possible to keep families together with services • State option- Starting 10/1/19, federal foster care entitlement can cover prevention to keep families together • MH/SUD services and in-home parenting skills training • Keep children with parents in inpatient SUD treatment • No income eligibility requirements!

  11. Family First Group Home Policies • Starting 10/1/19 Federal funds only pay for appropriate placements. • Categories of allowable settings • Quality requirements • Qualified assessment • Staffing • Accreditation • Trauma-informed treatment

  12. Legislative Advocacy • Earned Media AAP role in Family First • Policy Development

  13. AAP Chapter Role in Family First • State-based federal advocacy • Sign-on letters to federal policymakers • Earned media campaign participation • Thank you!

  14. Health Professionals Changed the Child Welfare Debate! • Existing dynamics protected status quo • Reform efforts approached success repeatedly • Epistemic legitimacy of health professionals in child welfare policy

  15. The Persistence of Advocacy • Policies the field pursued for over 30 years • Massive opposition from entrenched interests • FFPSA efforts began in 2015 • “The least dead we’ve ever been!” • How did we get here? Child health advocates never quit!

  16. Forward on Family First • Efforts now turn to implementation • AAP extensively engaged • Chapters have a significant opportunity in advocacy and policy discussions • AAP engaging foundation partners to support work with chapters

  17. What Can Chapters Do? • State advocacy to take up prevention opportunity • Earned media • Educate partners • Coalition building: • Medicaid • MH/SUD • Children’s health

  18. The Kansas case Study • Dr. Shaw’s op-ed • Foundation partner interest • Partnership with KAAP on briefings for legislators • 40-person advocacy day on Family First • Private meeting with Gov. Kelly

  19. Questions? zlaris@aap.org

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