IB 
Union Calendar No. 487 
114TH CONGRESS 
2D SESSION 
H. R. 5456 
[Report No. 114–628] 
To amend parts B and E of title IV of the Social Security Act to invest 
in funding prevention and family services to help keep children safe 
and supported at home, to ensure that children in foster care are placed 
in the least restrictive, most family-like, and appropriate settings, and 
for other purposes. 
IN THE HOUSE OF REPRESENTATIVES 
JUNE 13, 2016 
Mr. BUCHANAN (for himself, Mr. LEVIN, Mr. BOUSTANY, Mrs. BLACK, Mr. 
REED, Mr. KELLY of Pennsylvania, Mr. DOLD, Mr. LARSON of Con-
necticut, Mr. BLUMENAUER, Mr. PASCRELL, Mr. CROWLEY, Mr. DANNY 
K. DAVIS of Illinois, and Ms. LINDA T. SA´NCHEZ of California) intro-
duced the following bill; which was referred to the Committee on Ways 
and Means 
JUNE 21, 2016 
Additional sponsors: Ms. BASS, Mr. REICHERT, Mr. LANGEVIN, Mr. PAULSEN, 
and Mr. FRANKS of Arizona 
JUNE 21, 2016 
Reported with an amendment, committed to the Committee of the Whole 
House on the State of the Union, and ordered to be printed 
[Strike out all after the enacting clause and insert the part printed in italic] 
[For text of introduced bill, see copy of bill as introduced on June 13, 2016] 
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A BILL 
To amend parts B and E of title IV of the Social Security 
Act to invest in funding prevention and family services 
to help keep children safe and supported at home, to 
ensure that children in foster care are placed in the 
least restrictive, most family-like, and appropriate set-
tings, and for other purposes. 
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Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
SECTION 1. SHORT TITLE. 
This Act may be cited as the ‘‘Family First Prevention 
Services Act of 2016’’. 
SEC. 2. TABLE OF CONTENTS. 
The table of contents for this Act is as follows: 
Sec. 1. Short title. 
Sec. 2. Table of contents. 
TITLE I—INVESTING IN PREVENTION AND FAMILY SERVICES 
Sec. 101. Purpose. 
Subtitle A—Prevention Activities Under Title IV–E 
Sec. 111. Foster care prevention services and programs. 
Sec. 112. Foster care maintenance payments for children with parents in a li-
censed residential family-based treatment facility for substance 
abuse. 
Sec. 113. Title IV–E payments for evidence-based kinship navigator programs. 
Subtitle B—Enhanced Support Under Title IV–B 
Sec. 121. Elimination of time limit for family reunification services while in fos-
ter care and permitting time-limited family reunification serv-
ices when a child returns home from foster care. 
Sec. 122. Reducing bureaucracy and unnecessary delays when placing children in 
homes across State lines. 
Sec. 123. Enhancements to grants to improve well-being of families affected by 
substance abuse. 
Subtitle C—Miscellaneous 
Sec. 131. Reviewing and improving licensing standards for placement in a rel-
ative foster family home. 
Sec. 132. Development of a statewide plan to prevent child abuse and neglect fa-
talities. 
Sec. 133. Modernizing the title and purpose of title IV–E. 
Sec. 134. Effective dates. 
TITLE II—ENSURING THE NECESSITY OF A PLACEMENT THAT IS 
NOT IN A FOSTER FAMILY HOME 
Sec. 201. Limitation on Federal financial participation for placements that are 
not in foster family homes. 
Sec. 202. Assessment and documentation of the need for placement in a qualified 
residential treatment program. 
Sec. 203. Protocols to prevent inappropriate diagnoses. 
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Sec. 204. Additional data and reports regarding children placed in a setting that 
is not a foster family home. 
Sec. 205. Effective dates; application to waivers. 
TITLE III—CONTINUING SUPPORT FOR CHILD AND FAMILY 
SERVICES 
Sec. 301. Supporting and retaining foster families for children. 
Sec. 302. Extension of child and family services programs. 
Sec. 303. Improvements to the John H. Chafee Foster Care Independence Pro-
gram and related provisions. 
TITLE IV—CONTINUING INCENTIVES TO STATES TO PROMOTE 
ADOPTION AND LEGAL GUARDIANSHIP 
Sec. 401. Reauthorizing adoption and legal guardianship incentive programs. 
TITLE V—TECHNICAL CORRECTIONS 
Sec. 501. Technical corrections to data exchange standards to improve program 
coordination. 
Sec. 502. Technical corrections to State requirement to address the developmental 
needs of young children. 
TITLE VI—ENSURING STATES REINVEST SAVINGS RESULTING 
FROM INCREASE IN ADOPTION ASSISTANCE 
Sec. 601. Delay of adoption assistance phase-in. 
Sec. 602. GAO study and report on State reinvestment of savings resulting from 
increase in adoption assistance. 
TITLE I—INVESTING IN PREVEN-
TION AND FAMILY SERVICES 
SEC. 101. PURPOSE. 
The purpose of this title is to enable States to use Fed-
eral funds available under parts B and E of title IV of 
the Social Security Act to provide enhanced support to chil-
dren and families and prevent foster care placements 
through the provision of mental health and substance abuse 
prevention and treatment services, in-home parent skill- 
based programs, and kinship navigator services. 
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Subtitle A—Prevention Activities 
Under Title IV–E 
SEC. 111. FOSTER CARE PREVENTION SERVICES AND PRO-
GRAMS. 
(a) STATE OPTION.—Section 471 of the Social Secu-
rity Act (42 U.S.C. 671) is amended— 
(1) in subsection (a)(1), by striking ‘‘and’’ and 
all that follows through the semicolon and inserting ‘‘, 
adoption assistance in accordance with section 473, 
and, at the option of the State, services or programs 
specified in subsection (e)(1) of this section for chil-
dren who are candidates for foster care or who are 
pregnant or parenting foster youth and the parents or 
kin caregivers of the children, in accordance with the 
requirements of that subsection;’’; and 
(2) by adding at the end the following: 
‘‘(e) PREVENTION AND FAMILY SERVICES AND PRO-
GRAMS.— 
‘‘(1) IN
GENERAL.—Subject to the succeeding 
provisions of this subsection, the Secretary may make 
a payment to a State for providing the following serv-
ices or programs for a child described in paragraph 
(2) and the parents or kin caregivers of the child 
when the need of the child, such a parent, or such a 
caregiver for the services or programs are directly re-
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lated to the safety, permanence, or well-being of the 
child or to preventing the child from entering foster 
care: 
‘‘(A) MENTAL
HEALTH
AND
SUBSTANCE 
ABUSE
PREVENTION
AND
TREATMENT
SERV-
ICES.—Mental health and substance abuse pre-
vention and treatment services provided by a 
qualified clinician for not more than a 12-month 
period that begins on any date described in 
paragraph (3) with respect to the child. 
‘‘(B) IN-HOME PARENT SKILL-BASED PRO-
GRAMS.—In-home parent skill-based programs 
for not more than a 12-month period that begins 
on any date described in paragraph (3) with re-
spect to the child and that include parenting 
skills training, parent education, and individual 
and family counseling. 
‘‘(2) CHILD DESCRIBED.—For purposes of para-
graph (1), a child described in this paragraph is the 
following: 
‘‘(A) A child who is a candidate for foster 
care (as defined in section 475(13)) but can re-
main safely at home or in a kinship placement 
with receipt of services or programs specified in 
paragraph (1). 
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‘‘(B) A child in foster care who is a preg-
nant or parenting foster youth. 
‘‘(3) DATE DESCRIBED.—For purposes of para-
graph (1), the dates described in this paragraph are 
the following: 
‘‘(A) The date on which a child is identified 
in a prevention plan maintained under para-
graph (4) as a child who is a candidate for foster 
care (as defined in section 475(13)). 
‘‘(B) The date on which a child is identified 
in a prevention plan maintained under para-
graph (4) as a pregnant or parenting foster 
youth in need of services or programs specified 
in paragraph (1). 
‘‘(4) REQUIREMENTS
RELATED
TO
PROVIDING 
SERVICES AND PROGRAMS.—Services and programs 
specified in paragraph (1) may be provided under 
this subsection only if specified in advance in the 
child’s prevention plan described in subparagraph (A) 
and the requirements in subparagraphs (B) through 
(E) are met: 
‘‘(A) PREVENTION PLAN.—The State main-
tains a written prevention plan for the child that 
meets the following requirements (as applicable): 
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‘‘(i) CANDIDATES.—In the case of a 
child who is a candidate for foster care de-
scribed in paragraph (2)(A), the prevention 
plan shall— 
‘‘(I) identify the foster care pre-
vention strategy for the child so that 
the child may remain safely at home, 
live temporarily with a kin caregiver 
until 
reunification 
can 
be 
safely 
achieved, or live permanently with a 
kin caregiver; 
‘‘(II) list the services or programs 
to be provided to or on behalf of the 
child to ensure the success of that pre-
vention strategy; and 
‘‘(III) comply with such other re-
quirements as the Secretary shall es-
tablish. 
‘‘(ii) PREGNANT OR PARENTING FOS-
TER YOUTH.—In the case of a child who is 
a pregnant or parenting foster youth de-
scribed in paragraph (2)(B), the prevention 
plan shall— 
‘‘(I) be included in the child’s case 
plan required under section 475(1); 
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‘‘(II) list the services or programs 
to be provided to or on behalf of the 
youth to ensure that the youth is pre-
pared (in the case of a pregnant foster 
youth) or able (in the case of a par-
enting foster youth) to be a parent; 
‘‘(III) describe the foster care pre-
vention strategy for any child born to 
the youth; and 
‘‘(IV) comply with such other re-
quirements as the Secretary shall es-
tablish. 
‘‘(B) TRAUMA-INFORMED.—The services or 
programs to be provided to or on behalf of a 
child are provided under an organizational 
structure and treatment framework that involves 
understanding, recognizing, and responding to 
the effects of all types of trauma and in accord-
ance with recognized principles of a trauma-in-
formed approach and trauma-specific interven-
tions to address trauma’s consequences and fa-
cilitate healing. 
‘‘(C) ONLY SERVICES AND PROGRAMS PRO-
VIDED IN ACCORDANCE WITH PROMISING, SUP-
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PORTED, OR WELL-SUPPORTED PRACTICES PER-
MITTED.— 
‘‘(i) IN GENERAL.—Only State expend-
itures for services or programs specified in 
subparagraph (A) or (B) of paragraph (1) 
that are provided in accordance with prac-
tices that meet the requirements specified in 
clause (ii) of this subparagraph and that 
meet the requirements specified in clause 
(iii), (iv), or (v), respectively, for being a 
promising, supported, or well-supported 
practice, shall be eligible for a Federal 
matching 
payment 
under 
section 
474(a)(6)(A). 
‘‘(ii) GENERAL
PRACTICE
REQUIRE-
MENTS.—The general practice requirements 
specified in this clause are the following: 
‘‘(I) The practice has a book, 
manual, or other available writings 
that specify the components of the 
practice protocol and describe how to 
administer the practice. 
‘‘(II) There is no empirical basis 
suggesting that, compared to its likely 
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benefits, the practice constitutes a risk 
of harm to those receiving it. 
‘‘(III) If multiple outcome studies 
have been conducted, the overall weight 
of evidence supports the benefits of the 
practice. 
‘‘(IV) Outcome measures are reli-
able and valid, and are administrated 
consistently and accurately across all 
those receiving the practice. 
‘‘(V) There is no case data sug-
gesting a risk of harm that was prob-
ably caused by the treatment and that 
was severe or frequent. 
‘‘(iii) PROMISING PRACTICE.—A prac-
tice shall be considered to be a ‘promising 
practice’ if the practice is superior to an 
appropriate comparison practice using con-
ventional standards of statistical signifi-
cance (in terms of demonstrated meaningful 
improvements in validated measures of im-
portant child and parent outcomes, such as 
mental health, substance abuse, and child 
safety and well-being), as established by the 
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results or outcomes of at least 1 study 
that— 
‘‘(I) was rated by an independent 
systematic review for the quality of the 
study design and execution and deter-
mined to be well-designed and well-exe-
cuted; and 
‘‘(II) utilized some form of control 
(such as an untreated group, a placebo 
group, or a wait list study). 
‘‘(iv) SUPPORTED PRACTICE.—A prac-
tice shall be considered to be a ‘supported 
practice’ if— 
‘‘(I) the practice is superior to an 
appropriate comparison practice using 
conventional standards of statistical 
significance (in terms of demonstrated 
meaningful improvements in validated 
measures of important child and par-
ent outcomes, such as mental health, 
substance abuse, and child safety and 
well-being), as established by the re-
sults or outcomes of at least 1 study 
that— 
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‘‘(aa) was rated by an inde-
pendent systematic review for the 
quality of the study design and 
execution and determined to be 
well-designed and well-executed; 
‘‘(bb) was a rigorous ran-
dom-controlled trial (or, if not 
available, a study using a rig-
orous quasi-experimental research 
design); and 
‘‘(cc) was carried out in a 
usual care or practice setting; and 
‘‘(II) the study described in sub-
clause (I) established that the practice 
has a sustained effect (when compared 
to a control group) for at least 6 
months beyond the end of the treat-
ment. 
‘‘(v) WELL-SUPPORTED PRACTICE.—A 
practice shall be considered to be a ‘well- 
supported practice’ if— 
‘‘(I) the practice is superior to an 
appropriate comparison practice using 
conventional standards of statistical 
significance (in terms of demonstrated 
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meaningful improvements in validated 
measures of important child and par-
ent outcomes, such as mental health, 
substance abuse, and child safety and 
well-being), as established by the re-
sults or outcomes of at least 2 studies 
that— 
‘‘(aa) were rated by an inde-
pendent systematic review for the 
quality of the study design and 
execution and determined to be 
well-designed and well-executed; 
‘‘(bb) were rigorous random- 
controlled trials (or, if not avail-
able, studies using a rigorous 
quasi-experimental research de-
sign); and 
‘‘(cc) were carried out in a 
usual care or practice setting; and 
‘‘(II) at least 1 of the studies de-
scribed in subclause (I) established that 
the practice has a sustained effect 
(when compared to a control group) for 
at least 1 year beyond the end of treat-
ment. 
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‘‘(D) GUIDANCE
ON
PRACTICES
CRITERIA 
AND PRE-APPROVED SERVICES AND PROGRAMS.— 
‘‘(i) IN GENERAL.—Not later than Oc-
tober 1, 2018, the Secretary shall issue guid-
ance to States regarding the practices cri-
teria required for services or programs to 
satisfy the requirements of subparagraph 
(C). The guidance shall include a pre-ap-
proved list of services and programs that 
satisfy the requirements. 
‘‘(ii) UPDATES.—The Secretary shall 
issue updates to the guidance required by 
clause (i) as often as the Secretary deter-
mines necessary. 
‘‘(E) OUTCOME ASSESSMENT AND REPORT-
ING.—The State shall collect and report to the 
Secretary the following information with respect 
to each child for whom, or on whose behalf men-
tal health and substance abuse prevention and 
treatment services or in-home parent skill-based 
programs are provided during a 12-month pe-
riod beginning on the date the child is deter-
mined by the State to be a child described in 
paragraph (2): 
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‘‘(i) The specific services or programs 
provided and the total expenditures for each 
of the services or programs. 
‘‘(ii) The duration of the services or 
programs provided. 
‘‘(iii) In the case of a child described 
in paragraph (2)(A), the child’s placement 
status at the beginning, and at the end, of 
the 1-year period, respectively, and whether 
the child entered foster care within 2 years 
after being determined a candidate for fos-
ter care. 
‘‘(5) STATE PLAN COMPONENT.— 
‘‘(A) IN GENERAL.—A State electing to pro-
vide services or programs specified in paragraph 
(1) shall submit as part of the State plan re-
quired by subsection (a) a prevention services 
and programs plan component that meets the re-
quirements of subparagraph (B). 
‘‘(B) PREVENTION
SERVICES
AND
PRO-
GRAMS PLAN COMPONENT.—In order to meet the 
requirements of this subparagraph, a prevention 
services and programs plan component, with re-
spect to each 5-year period for which the plan 
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component is in operation in the State, shall in-
clude the following: 
‘‘(i) How providing services and pro-
grams specified in paragraph (1) is ex-
pected to improve specific outcomes for chil-
dren and families. 
‘‘(ii) How the State will monitor and 
oversee the safety of children who receive 
services and programs specified in para-
graph (1), including through periodic risk 
assessments throughout the period in which 
the services and programs are provided on 
behalf of a child and reexamination of the 
prevention plan maintained for the child 
under paragraph (4) for the provision of the 
services or programs if the State determines 
the risk of the child entering foster care re-
mains high despite the provision of the serv-
ices or programs. 
‘‘(iii) With respect to the services and 
programs specified in subparagraphs (A) 
and (B) of paragraph (1), information on 
the specific promising, supported, or well- 
supported practices the State plans to use to 
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