Family First

Family First limits the use of child care institutions (residential treatment programs, group homes and foster residences) to children who cannot receive services within their family or family foster homes. Only when they cannot receive services in those settings is a placement in a child care institution considered to be in the best interest of a child.

These new requirements were established to transform the child welfare system, to keep children and families together, and to preserve family connections when placements are necessary.

Family First expands federal reimbursement to include prevention services for mental health and substance abuse treatment, and in-home parenting skill-based programs for parents or kin caring for children at-risk of entering foster care. The broad categories of prevention services eligible for reimbursement are: 

• Mental health and substance abuse prevention and treatment services provided by a qualified clinician 
• In-home parent skill-based programs that include parenting skills training, parent education, and individual and family counseling 
• Kinship navigator programs that help kinship caregivers access programs and services to address their needs and the needs of children in their care in a way that is meaningful for their family. 

Prevention services must be:

• Rated and approved as promising, supported or well-supported by and in accordance with the federal Title IV-E Prevention Services Clearinghouse
• Identified in the state’s five-year prevention plan as services that prevent child maltreatment and the unnecessary removal of children from their families while keeping children safe.

Family First creates four specialized settings for children placed in child care institutions based on the needs of a child. 

• Qualified residential treatment program (QRTP) 
• Pregnant or parenting youth (PPY) 
• Youth who have been or are at risk of sex trafficking or commercial sexual exploitation (STY) 
• Extended foster care youth in supervised independent living settings (SILS). 

New requirements apply to children placed on or after Sept. 30, 2021, in one of the four specialized settings. The Family First residential placement requirements apply to all children regardless of an individual child’s Title IV-E status. Children and youth must meet certain criteria to be placed in one of the four specialized settings. 

In Minnesota, county and tribal agencies are responsible for implementing out-of-home placement policies and practices. Family First introduces new protections for children when a county or tribal juvenile treatment screening team recommends a child be placed in a QRTP.