Investigating Child Welfare Outcomes in Kansas: A Prevention Perspective Under the Family First Act (FFPSA)

Background: The Family First Prevention Services Act (FFPSA), passed as legislation in 2018, serves children at ‘imminent’ risk of removal who can remain safely at home with services. Although the FFPSA represents a major transformative step in federal child welfare reform, little is known about how the reforms translate into meaningful outcomes for children and families. This study examines how Family First performs with respect to preventing the removal of children compared to other prevention services in a mid-western state. Specifically, this study aims to: (1) estimate and interpret removal of children through Family First, Family Preservation and Family Services; (2) compare relative risk of removal between the three programs; and (3) assess the relationship of demographic variables to removal time.

Methods: A retrospective cohort study was conducted using administrative data from the state’s child welfare agency spanning a four-year period from October 1, 2019- March 31, 2023. Data on demographic characteristics of children, reasons for removal from their homes, and types of services were collected. Survival analysis techniques including Kaplan-Meier curves and Cox proportional hazards models were employed to assess the association between various factors and child removal outcomes.

Results: The study included a cohort of 14,990 children who were referred to prevention services by the DCF Prevention and Protection Division. Results are as follows: (1) For the children that received Family First services, the survival probability after one-year of receiving services was 0.97. (2) Compared to Family Preservation, Family First decreases the risk of entering foster care by 51% (HR = .49; p < .00) in the short-term and by 39% (HR = .61; p < .00) in the long-term. (3) Survival probability after one-year of receiving Family First services did not vary significantly by demographic factors such as age or gender. However, when considering long-term hazard ratios (~4 years), children in the 12+ age group showed increased risk compared to other age groups.

Implications: These findings provide valuable insights into the factors influencing child removal outcomes in one state. While all three preventive services were successful at reducing risk of foster care entry for more than 90% of children served (survival probability >0.90), Family First performs just as well or better than existing programs. In this case, receiving Family First services was associated with reduced risk of removal into foster care by 51% in the short-term and nearly 39% in the long-term compared to other services. It is also the only program that significantly reduced risk in the long-term. Therefore, there is a need to expand the array of preventive services offered through Family First to keep children out of foster care.