Families of children who come in contact with the child welfare system often face a number of difficult challenges, many often deeply associated with poverty, such as underemployment, a lack of secure housing, and other social determinants of health. Such challenges can be exacerbated or caused by mental health concerns, substance use disorders, domestic violence, and a number of other complex societal issues. Parental substance use disorders are a key factor underlying the abuse or neglect experienced by many of the children who enter foster care or are at risk of entering foster care. According to Child Maltreatment 2016, which uses National Child Abuse and Neglect Data System (NCANDS) data, 74.8 percent of the children determined by the child protective services agency to be victims of child maltreatment were neglected. When a parent is dependent on substances, including opioids, chronic neglect of the child becomes more likely. Additionally, according to the Adoption and Foster Care Analysis and Reporting System (AFCARS) data, the number of children in foster care increased to approximately 443,000 in fiscal year (FY) 2017. Of the 15 categories states can report for the circumstances associated with a child’s removal from home and placement into care, drug abuse by a parent had the largest percentage point increase, from 34 percent in FY 2016 to 36 percent in FY 2017. Slightly more than 96,700 children were removed from their home in FY 2017 because at least one parent had a drug abuse issue.
Historically, the provision of child welfare services and substance abuse treatment is uncoordinated and fragmented. Reasons for fragmentation among the multiple systems serving families with substance use disorders include the following:
- Difficulty of identifying, engaging, and retaining parents/caretakers in substance abuse treatment;
- Differing perspectives, policies, time tables for completing treatment, and expectations between child welfare workers and substance abuse treatment providers; and
- Lack of appropriate comprehensive family-centered treatment services for families involved in both the child welfare and substance abuse treatment systems.
To improve the understanding of the relationship between child welfare caseload rates and indicators of substance prevalence, the U.S. Department of Health Human Services’ Office of the Assistance Secretary for Planning and Evaluation (ASPE) conducted a mix-methods study from 2017-2018. Through qualitative methods, including in-depth interviews, the study also captured the perspectives and experiences of child welfare and related professionals from across the country. Key findings from this effort include:
- Generally, counties with higher rates of drug overdose, death, and drug hospitalization rates have higher child welfare caseload rates, and these substance use indicators correlate with rates of more complex and severe child welfare cases.
- Availability and use of substance use treatment continues to be a challenge. Family-friendly treatment options are limited, and caseworkers, courts, and other providers often misunderstand how treatment works and lack guidelines on how to incorporate it into child welfare practice.
- Child welfare agencies and their community partners continue to struggle to meet the needs of families affected by substance use disorders. Disorganized substance use assessment practices, barriers to collaboration with substance use treatment providers and other stakeholders, and shortages of foster homes and trained staff undermine the effectiveness of agencies’ responses to families.
Children's Bureau's (CB) vision for child welfare is to support families and strengthen communities in ways that will prevent maltreatment and keep children with their families and in their communities. To achieve this vision families must be able to access comprehensive, evidence-based, and evidence-informed programming, as well as basic supports and resources with their communities through their local child and family-serving agencies and other key public and private partners.
As the field of child abuse and neglect has begun to better understand the far-reaching detrimental impact of substance use disorders on children and families, as well as how to best improve outcomes for children and their families, the need for strong collaboration across child welfare, substance use treatment, and the courts continues to be clearly demonstrated. An important challenge facing both the child welfare and the substance use disorder treatment fields is the need to take a comprehensive view of families' situations and to understand the contributions of various problematic behaviors that lead to child maltreatment and address these issues utilizing a family-centered approach. Furthermore, quality substance abuse treatment programs designed for parents involved with the child welfare system, especially treatment programs that target women with young children, and utilize a family-centered approach, are not widely available, and when available, they do not strategically target the well-being and functioning of children served.
REGIONAL PARTNERSHIP GRANTS
The Child and Family Services Improvement Act of 2006 reauthorized the Promoting Safe and Stable Families (PSSF) program and provided funding over a 5-year period to implement a targeted grant program to Regional Partnerships for the purpose of improving permanency outcomes for children affected by methamphetamine and/or substance abuse. This legislation was in direct response to the recognition that parental substance abuse is a key factor underlying the abuse or neglect experienced by many children in the child welfare system.
The report to Congress on the RPG Round 1 grants can be found at: https://www.acf.hhs.gov/cb/resource/targeted-grants-to-increase-the-well-being
Regional Partnership Grants Round 6
In 2018, the President signed the Bipartisan Budget Act of 2018 (Pub .L. 115-123) into law, reauthorizing the RPG program through 2021. As part of the reauthorization, several changes were made to the RPG program primarily including a change in the required mandatory partners and a newly required Planning Phase, not to exceed 2 years or a funding disbursement of $250,000.
The RPG projects seeks to expand the evidence base of programs and practices in the broader fields of child welfare and substance abuse treatment. The RPG program does so by: (1) requiring grantees to identify and use appropriate practices that are indicated by evidence to be well-supported, supported, promising, or emerging practices, (2) encouraging grantees to consider adapting these practices for their target populations if needed, and (3) incorporating local and cross-site evaluation into the grant program in order to expand the evidence base on services for families involved in the child welfare and substance abuse treatment systems. By collecting and analyzing multiple sources of data, ACF will be able to provide information on the effectiveness of the RPG program.
The remainder of this section highlights grantee requirements in the following areas:
Target Area and Population
The target area and population of the project should include communities in which there are a number of children in out-of-home placements or who are at risk of being placed in an out-of-home placement due to the substantial impact of opioid abuse and other substance abuse and have limited availability of resources for addressing the needs of children, adults, and families affected by substance use disorders.
Mandatory partners for Regional Partnerships now include the state child welfare agency that is responsible for the administration of the state plan under title IV-B or title IV-E of the Social Security Act, and the state agency responsible for administering the substance abuse prevention and treatment block grant provided under subpart II of part B of title XIX of the Public Health Service Act 42 U.S.C. 629(f)(2)(A). In addition, if the partnership will serve children in out-of-home placement, the collaboration must include the Juvenile Court or Administrative Office of the Courts that oversees the administration of court programs that address the population of families who come to the attention of the court due to child abuse or neglect.
Collaborations are required to include signed memoranda of agreement/understanding. In addition, collaborations may include the following components:
- Routine consultation and interaction with other agencies;
Joint accountability and shared outcomes clearly documented;
Cross training and staff development;
Processes for communication and information sharing;
Willingness and agreement to share administrative data for program evaluation and/or research;
Addressing how partners' values and principles help or hinder the collaboration; and
Having agreements about shared costs and budgets.
Program Strategies and Activities
Grantees will implement, in coordination with CB and CB-supported contractors, specific services and activities that address: increasing child and family well-being, improved treatment outcomes for parents, supporting the implementation of the Family First Prevention Services Act of 2018 (FFPSA), along with the more traditional goals of enhancing safety and improving permanency for children who are in or at risk of being placed in an out-of-home placement as a result of a parent or caretaker's substance abuse.
All grantees must select and report on performance indicators to measure improvement of child, adult, and/or family outcomes that align with their proposed program strategies and activities. CB-supported contractors will work with grantees after the award to assess, in detail, the fit of program strategies and activities for the identified target population and review how the quality of the program services and activities influence the intended outcomes of the grant. Therefore, grantees will work with the CB-supported contractors to make adjustments as needed after award to ensure that the RPG proposed project strategies and activities are well-defined. By identifying the core components of the proposed project and looking at the implementation of the strategies and activities, ACF expects to better understand the factors associated with the successful implementation and sustaining of program strategies and activities.
Examples of services and activities that grantees will engage in or integrate into existing service delivery systems include the following:
- Services and activities for children and youth that address child well-being and trauma, including screening and assessment of child well-being, enhancing identification and services to substance-exposed newborns, access to appropriate mental and behavioral health services, and early intervention and preventive services;
- Quality substance use disorder treatment for parents and families including access to comprehensive substance use disorder treatment programs where children can live on site with parents (often the mother). The programs are designed to meet the needs of the entire family by providing access to medication-assisted treatment, in-home substance use disorder treatment, trauma-specific services, and continuing care and recovery support;
- Services designed to specifically address violence and trauma-related symptoms and reactions; and
- Services for parents and children that improve parenting capacity and family functioning, including efforts to build or enhance parental protective factors, parenting skills training programs to address relational problems and concerns, training for foster or relative care providers, services and interventions to improve family functioning and assist with reunification, and ancillary services for families to support securing needed services including housing, transportation, and child care.
Please see Appendix A for a further list of examples of services and activities for applicants to consider including as a part of their proposed project to engage in or integrate into existing service delivery.
Using Well-Supported, Supported, Promising, and/or Emerging Practices
Grantees will build upon and strengthen existing collaborative practices and fund services or practices that are indicated by evidence to be well-supported, supported, or promising, as well as those emerging practices that are appropriate and culturally responsive for the population of focus; and shown to be effective in achieving the outcomes of the grant. Grantees are required to: (1) identify the well-supported, supported, promising, and/or innovative emerging (evidence-informed) practices they plan to use; (2) provide evidence that shows the practices to be effective; (3) commit and support the implementation of practices; and (4) provide a rationale for using the practices in the identified community with the identified target population. "Indicated by evidence" refers to approaches that are validated by some form of documented research evidence.
The following resources may assist RPGs in selecting practices that are well-supported, supported, promising, and/or emerging practices:
The preceding sources do not list all of the available well-supported, supported, promising and/or emerging practices. Grantees may use information from other sources, e.g. unpublished studies or documents describing formal consensus among recognized experts.
Planning and Implementation Phases
This FOA requires a 1-year planning phase. The Children’s Bureau is open to flexibilities and is committed to supporting grantees in the most effective strategies for the implementation of the proposed projects. Depending on the readiness of any individual program and the complexity of the proposal, a grantee could be approved to begin the Implementation Phase in less than 12 months. Due to requirements in the statute, grantees must spend no more than $250K in the planning phase and no less than $250K per year. As a result the planning phase is limited to a maximum of $250K and one year.
Based upon the results of the comprehensive set of activities undertaken during the Planning Phase, grantees will develop a detailed, revised implementation and evaluation plan to guide the Implementation Phase of their projects. This revised plan will be submitted to CB during the ninth month of the Planning Phase, to be reviewed and approved by CB. The revised plan will include details of their governance and management structure guiding their Regional Partnership; detail their target population, projections for numbers served, eligibility criteria and referral and recruitment processes; RPG programs and strategies to be implemented, work plan for the Implementation Phase; revised logic model that outlines an overall theory of change for the Regional Partnership (including a review of their states' Child and Family Services Plan (CFSP), and when appropriate, seeking opportunities to engage with relevant state level efforts); plan for a rigorous local evaluation and participation in the cross-site evaluation, including a detailed data collection plan; and sustainability and dissemination plans.
During the Planning Phase, grantees will engage in intensive assessment and planning activities in which grantees will build on their proposed project plan that was clearly described in their applications to further refine and finalize their implementation and local evaluation plans, as well as finalize their performance data indicator selections. Projects will work with a federally funded, cross-site evaluation and technical assistance team to further develop and refine the strongest possible evaluation plans for the Implementation Phase of the project. Such efforts will also include work to bring local evaluation designs into alignment with the cross-site evaluation, including in regard to design, methodologies, and measures. The degree to which such alignment is possible will be determined over the course of the Planning Phase. Adjustments to their implementation and evaluation plans may be necessary upon further refinement of the target population and in consultation with CB and technical assistance providers.
The purpose of the planning period is to:
- Finalize all outstanding partnership agreements necessary to support successful implementation of the Regional Partnership project;
- Further define the target population and finalize program eligibility and referral and recruitment plans to ensure the project meets goals for targeted numbers served to optimize the success of the program and the rigorous local evaluation;
- Ensure the appropriateness and fit of the selected program(s), models, interventions, and/or services for the targeted children and their families;
- Assess the capacity and readiness of the lead agency and key partnering agencies for the implementation of RPG services;
- Further refine the evaluation plan to be as rigorous as possible;
- Finalize performance indicators and outcome selections;
- Ensure the final evaluation plan is reviewed by the relevant Institutional Review Board(s) (IRB), and their approval is obtained, or ensure a sound plan is in place to obtain IRB approval; and
- Ensure the necessary data sharing agreements are in place to secure the administrative data needed to support both the local and cross-site evaluation.
The Implementation Phase of the project cannot begin until the revised implementation and evaluation plan has been approved by CB. After the revised implementation and evaluation plan is approved by CB, grantees are required to have the project and the implementation of services fully functioning as described in their timeline.
ACF expects that projects funded under this FOA will help build the evidence base for innovative interventions that will enhance well-being and improve outcomes for children and families affected by a parent or caretaker’s substance abuse. The evaluation and reporting on performance measures for this cooperative agreement requires a great deal more effort than is typical for discretionary grants. Grantees will adopt and fully implement specific, well-defined, and quality program services and activities that are indicated by evidence and/or evidence-informed. Grantees are to conduct a rigorous site-specific local evaluation that analyzes the implementation, including evaluation to improve processes and services, performance, and outcomes, including demonstrating linkages between proposed interventions and improved outcomes of the grant project. ACF is specifically interested in determining the impact of these programs on improving outcomes for children and families in the key areas of increased well-being, improved permanency, enhanced safety, recovery, and family stability. Also, ACF is interested in the use of rigorous rapid cycle evaluation methodologies, specifically in the area of referrals, recruitment, and retention of clients to RPG services to identify successful strategies that improve the ability to direct referrals to available and appropriate services and engage clients to participate in such services. Grantees must implement a local evaluation plan of sufficient rigor to assess impacts on service delivery and outcomes for the targeted population and to contribute to the evidence base for approaches that improve well-being and functionality for families affected by substance use disorders. Pilot testing or rapid cycle learning evaluation may be a part of the local evaluation during the Planning Phase, but the start of such efforts must be approved by CB. Results from pilot testing or rapid cycle learning that occurs during the Planning Phase should inform the implementation and evaluation plan developed and finalized during the Planning Phase, as well as further work on the project.
In addition to conducting a local evaluation, grantees must participate fully in a national cross- site evaluation in which an ACF-supported contractor analyzes the performance and/or outcomes of multiple projects that are funded under the grant program. Grantees must devote a minimum of 20 percent of their project budget to data collection and evaluation activities. The cross-site evaluation will describe outcomes for children, adults, and families enrolled in RPG projects and the outcomes of the partnerships. Grantees must collect and submit the required information and performance indicator data for the national cross-site evaluation. For more information about current and past cross-site evaluations including cross-site evaluation design reports, Reports to Congress, and other related publications, please visit: https://www.mathematica-mpr.com/our-publications-and-findings/publications/regional-partnership-grant-program-cross-site-evaluation-design-report
Per the legislative requirements, grantees are required to evaluate their local program, finalize their performance indicator selections with the assistance of the CB-supported contractor, and report on those selections. The grantees' proposed program strategies and activities must align with their selection of proposed performance indicators. Please see in Appendix A for a list of potential outcomes, performance indicators, and measures. Legislation requires that ACF report on grantees' success in meeting performance indicators and addressing the needs of families with substance abuse problems. In order to meet this requirement, ACF will review and analyze a number of data sources collected and reported by grantees.
ACYF/CB recognizes that when our discretionary grantees are able to access relevant child welfare data from child welfare agencies for the children and family participants in their grant projects, they are better able to assess performance and outcomes or complete their required evaluations. Grantees are encouraged to review Information Memorandum (IM) ACYF-CB-IM- 13-02, which encourages child welfare agencies to share relevant child welfare data on the families and children served with CB discretionary grantees and related federally funded grant projects for program evaluation, performance measurement, or research purposes. See http//www.acf.hhs.gov/sites/default/files/cb/im1302.pdf .
Projects are required to have their own skilled evaluator to conduct the local evaluation of the project and support their participation in the cross-site evaluation. If the applicant does not have the in-house capacity to conduct an objective and comprehensive evaluation of the project, the applicant must propose contracting with a third-party evaluator specializing in social science or evaluation or a university or college to conduct the evaluation. In either case, it is important that the evaluator demonstrate the necessary independence from the project to ensure objectivity. In addition, projects and their evaluators are required to work closely with the designated cross-site evaluation and evaluation technical assistance contract provider, as well as CB, in activities that support projects in conducting their evaluation, participation in the cross-site evaluation, as well as other federally led evaluation activities.
The proposed evaluator must have sufficient experience with research and/or evaluation design and methods, including continuous quality improvement, understand the target population and have experience in obtaining and analyzing child welfare data. The proposed evaluator must have experience successfully implementing human services evaluations utilizing research designs similar to the proposed effort. A skilled evaluator must be able to help develop a logic model, assist in design, and provide rigorous evaluation strategies that are rigorous appropriate given the goals and objectives of the proposed project. Other important experiences to demonstrate include selecting measures, using existing data systems as a source of evaluation information, and collecting data that are reliable and valid.
Additional assistance may be found in a document titled "Program Manager's Guide to Evaluation." A copy of this document can be accessed at https://www.acf.hhs.gov/sites/default/files/opre/program_managers_guide_to_eval2010_508.pdf.
Well-being as a Special Consideration
A key intent of this FOA is to ensure that the well-being of all target populations will improve as a result of the programs and services offered by the grantees. CB anticipates that grantees will rely on existing theory and evidence-based knowledge to guide their activities and that the results of the evaluations will contribute to the body of evidence that demonstrates the impact of services that address substance use disorders and its effects on child and family well-being. CB recognizes that there are a variety of projects that can be responsive to this FOA and that grantees will represent a diverse set of activities and strategies that are intended to impact a number of outcomes. Nonetheless, this FOA requires that at a minimum, each grantee work to achieve at least one well-being measure indicator for children and one well-being indicator for adults (either proximal or distal).
The well-being of both children and parents or caretakers should improve as a result of the programs and services offered by the grantees. CB recognizes that well-being can be defined in a variety of ways (physical, social/emotional, cognitive, etc.), but grantees are required to give particular focus on the social/emotional well-being of their target population. This may include, but is not limited to, projects that target activities that will result in improvement in the following proximal outcomes: child and family functioning, parenting skills, developmental functioning, or protective factors such as resiliency, attachment, social connections and/or concrete supports for parents.
CB expects that grantees will be able to logically link and empirically support the connection between project activities that are designed to mitigate the effects of parental/caretaker substance abuse and the improved well-being of children in the child welfare system. Measuring the improvement of well-being could mean that a treatment group fared better on a proximal outcome than a control group or comparison group with similar characteristics that did not receive the benefits of the program provided by the grantee. It also could mean that graduation rates increase in the geographic area identified (a distal indicator). For the data collection and reporting of well-being measures, grantees are required to use valid and reliable instruments and to report case-specific baseline and subsequent data measurement points (e.g., pre- and post- scores) to demonstrate the results of their services and activities. Potential measurement tools that are included in the existing cross-site evaluation are listed in Appendix B.
Grantees will be expected to work throughout the course of their grants with federal project officers, the relevant CB training and technical assistance providers, and other grants in this program to:
- Finalize individual grant dissemination goals, objectives, and strategic plans;
- Identify and engage with target audiences for dissemination;
- Produce detailed procedures, materials, and other products based on the program evaluation and the needs of identified target audiences; and
- Develop and disseminate summarized/synthesized information about the grant.
Project Sustainability Plan
ACYF is interested in ensuring that the most effective program strategies, services, and interventions can be sustained. Grantees are required to establish a plan to address how they will maintain the identified strategies and activities initiated under this grant that should and can be sustained after the end of the project period. Such a plan may include the use of prevention services and programs as outlined under FFPSA within Division E, Title VII of the Bipartisan Budget Act of 2018, and other funds provided to the state for child welfare and substance abuse prevention and treatment services.