LANSING – The Michigan Department of Health and Human Services (MDHHS) is taking action so children are placed in residential foster care facilities only if that type of placement is necessary to meet their mental and behavioral health needs.

MDHHS launched a new Qualified Residential Treatment Program model for congregate care. This marks the achievement of a major milestone in implementing the federal Family First Prevention Services Act of 2018 – known as the Family First Act.

The Family First Act includes substantial reforms that states must achieve no later than Sept. 30, including implementation of the Qualified Residential Treatment Program, to maintain federal funding for residential foster care placements through Title IV-E of the Social Security Act.

“The implementation of these provisions signals the state’s commitment to serving children in family settings whenever possible,” said Stacie Bladen, interim executive director of the MDHHS Children’s Services Agency. “When children require residential services, the new congregate care model includes family and caregivers in treatment, and requires transition of youth back to their communities and families as soon as possible.”

This model is new to Michigan, having been created as part of the Family First Act and signed into law in 2020 by Gov. Gretchen Whitmer. It emphasizes the importance of trauma-informed treatment, which means that children’s treatment in foster care is based on the understanding that they have experienced trauma. The model also requires aftercare services for six months when a youth is discharged from congregate care.

Before the federal government will participate in cost-sharing for these services, a qualified independent assessor must review the youth’s case and determine within 30 days of admission that the child’s behavioral and mental health needs can only be met in a Qualified Residential Treatment Program and not in a community-based setting – such as being placed in a family foster home. Additionally, within 60 days of placement, the court must approve the child’s placement in the residential program.

In 2016, prior to passage of the Family First Act, MDHHS, residential provider agencies and stakeholders across the state embarked on transforming the system. The idea is to better target mental and behavioral health services, and the use of residential services for youth involved in foster care and juvenile justice to achieve better outcomes. This work prepared Michigan to be a leader in implementing the subsequent Qualified Residential Treatment Program provisions of the Family First Act.

Michigan’s residential provider community has been proactive in making changes to existing programs to meet the new federal requirements.

“Transitioning to become a Qualified Residential Treatment Program provider, which included eliminating the use of restraints, enhancing aftercare services, improving clinical interventions, and ensuring our young people and families were driving treatment, was a critical step for Methodist Children’s Home Society,” said Kevin Roach, CEO of Methodist Children’s Home Society in Redford. “In partnering with MDHHS, we were able to greatly improve safety and permanency, reduce the lengths of stay, and ensure our families were empowered and had bright futures.”

Angela Aufdemberge, president and CEO of Vista Maria, a private agency provider in Dearborn Heights, said: “The collaborative work between private agency partners and MDHHS to build our Qualified Residential Treatment Program implementation plan will bring improved care for children and outcomes for families. The requirements enable private partners to provide comprehensive, trauma informed care to youth and provide structure and supports to aid successful family reunification.”

MDHHS is required to certify that residential providers meet federal standards, including that the program is trauma-informed, includes an after-care component of at least six months, provides 24/7 nursing availability, meets Title IV-E licensing requirements and is accredited by a federally approved organization.

In addition to the new residential program, the Family First Act allows states to use federal Title IV-E dollars to support specialized settings, such as those designed to serve pregnant and parenting youth, youth 18 and older transitioning to adulthood in an independent living setting and youth who are or are at risk of becoming sex trafficking victims.

The Family First Act was passed by Congress with the intent to support children and families staying together, but when it is not possible, ensuring children are placed in a family foster home, related or unrelated, or as close to a family-like setting as feasible while meeting the child’s treatment needs.