Family First Prevention Services Act

Become accredited with COA, an approved accreditor of Qualified Residential Treatment Programs (QRTPs) under the Family First Prevention Services Act (FFPSA).

We’ve designed this page to help you understand the impact of this landmark legislation and how we can help. For more resources—including the latest national news, state news, and and resources from the field–visit our microsite at Ready to start the accreditation process? Reach out to us today.

What Family First is

The Family First Prevention Service Act (FFPSA) is U.S. legislation that was signed into law in February 2018. FFPSA restructures Title IV-E and Title IV-B funding to support prevention services for families at risk of entering the foster care system. Ideally, this will help to keep families together and prevent children from entering foster care unnecessarily.

Under FFPSA, only specified settings will be eligible for Title IV-E funding reimbursement. One of the eligible settings is a “Qualified Residential Treatment Program” (QRTP). Organizations can qualify as a QRTP if they:

  • Offer a trauma-informed treatment model
  • Have registered or licensed nursing staff available 24/7
  • Demonstrate family engagement and outreach
  • Provide discharge planning and family-based aftercare supports for at least 6 months post-discharge
  • Become licensed with their state, and
  • Achieve accreditation through an HHS-approved accreditor (such as COA).

How COA can help

We understand that many organizations are coming to accreditation for the first time because of this legislation. Some may be nervous about what to expect given their limited resources. Rest assured that our process is designed to work with you to encourage your success.

Each organization is assigned a dedicated Accreditation Coordinator to answer your questions. In addition, we have ample tools, trainings, and other resources to help you along the way. We’ve even developed a phased accreditation process to make it easier for you to meet your deadline. Contact us for more information.


We are offering free 30-minute webinars that are perfect for anyone seeking accreditation for the first time or interested in what is required to become accredited. Participants will gain an understanding of the key concepts that define COA, the steps toward becoming accredited, and the benefits of accreditation. There will also be a Q&A portion for us to answer any questions you might have!

“COA accreditation helps keep you focused on the things that matter. COA doesn’t dictate your mission. Instead, it helps you live your mission, and this helps promote long-lasting quality. Long after the reviewers are gone, the insights and systems last to promote quality and the proper service to those vulnerable populations that we serve.”

Jeff Peterson

Executive Director, Home Campus

Boys Town Nebraska/Iowa

Latest major updates


The Title IV- E Prevention Services Clearinghouse was established in accordance with FFPSA by the Administration for Children and Families (ACF) within the U.S. Department of Health and Human Services (HHS). The Clearinghouse’s goal is to conduct an objective, rigorous, and transparent review of research on programs and services intended to support children and families and prevent foster care placements.

Programs submitted to the Clearinghouse are rated as “well-supported,” “supported,” “promising practice,” or as “not meeting criteria.” The initial programs that have been rated include mental health services, substance abuse prevention and treatment services, in-home parent skill-based programs, and kinship navigator programs. Ratings will help determine programs’ eligibility for reimbursement through Title IV-E funding.

Find the Clearinghouse website here.


On December 20th, 2019, as part of the 2020 Further Consolidated Appropriations Act, the Family First Transition Act was signed into law. This legislation includes three main provisions:

  • $500 million in one-time transition funding to help states and tribes implement Family First (in some cases, this could include funds to help pay for accreditation)
  • A phase-in of the 50% “well-supported” requirement from the Clearinghouse for Title IV-E reimbursement
  • Short-term funding certainty for states with expiring waivers

View the legislation here.

For more information about FFPSA, visit