Child abuse and neglect are associated with high lifetime public costs across child welfare, health care, education, and justice systems. National estimates suggest the economic burden of child abuse and neglect investigations for a single annual cohort reaches into the trillions of dollars over affected individuals’ lifetimes. Foster care is a particularly costly intervention, with states reporting per-child placement costs that can approach or exceed tens of thousands of dollars. These costs increase with placement instability, longer stays in care, and re-entry into foster care. Preventing maltreatment and reducing unnecessary foster care placements can lower these long-term public costs while supporting child safety and family stability.

The Family First Prevention Services Act (Family First) shifted federal child welfare financing by allowing states to use Title IV-E funds for certain evidence-based prevention services that address some of the root causes of child abuse and neglect. Evidence from national research on families with infants and toddlers shows that prevention (e.g., home visiting, early childhood mental health supports, and pre- and post-natal services) can reduce foster care entry and generate long-term public cost savings. Since passage of the legislation, the national foster care entry rate has declined from 2018 to 2023, indicating possible early prevention effects. When a broad array of parents and families are reached across the population, prevention may be optimized, benefitting many types of families and likely improving additional outcomes (e.g., child mental health, early school readiness), making this approach cost effective and potentially de-stigmatizing for families at risk.

Family First 101

Family First allows federal reimbursement for kinship navigator programs, as well as three categories of evidence-based prevention services to prevent children from entering foster care:

• Mental Health Prevention and Treatment Programs and Services: Clinical services provided by qualified professionals to address caregivers’ or children’s behavioral and emotional needs
• Substance Use Prevention and Treatment Programs and Services:  Services that address caregiver or youth substance use or misuse
• Parent Skill-Based Programs and Services: Psychological, education or behavioral interventions or treatments that target parenting skills or other skills that contribute to parental protective capacity and children’s safety and well-being. These include home visiting programs, parenting education, training, and family-focused counseling delivered in home or community settings.

Family First Changed Financial Incentives Toward Prevention

Prior to Family First, federal child welfare funding largely reimbursed states only after children were removed from their homes. This structure limited investment in prevention and favored more expensive, downstream responses.

• States are increasingly using Family First as an opportunity to re-balance spending toward family-based prevention rather than costly placements.

Family First Evidence-Based Programs: Cost-Relevant Prevention Strategies

• These programs focus on strengthening parenting skills, preventing substance use, addressing behavioral and emotional challenges, reducing stress, and improving family functioning.
• Education-based parenting programs generally cost far less than foster care or residential placements.
• Evidence shows that these programs can reduce maltreatment recurrence and lower the likelihood of foster care entry.
• By preventing or shortening placements, family supportive programs offer a pathway to cost avoidance while maintaining child safety.
• Several widely implemented parenting programs have also demonstrated measurable returns on investment (ROI), meaning the long-term financial benefits exceed the upfront costs.

Return on Investment: Evidence from Established Family Strengthening Programs

Several evidence-based programs that are on the IV-E Prevention Services Clearinghouse show that prevention can produce financial returns that exceed program costs. These financial benefits reflect avoided costs related to child welfare involvement, health care, behavioral health services, education systems, and justice system contact. While program costs vary by model and implementation setting, the evidence suggests that well-implemented parenting programs can generate long-term savings that outweigh initial investments.

• The Triple P – Positive Parenting Program demonstrated an estimated $8.87 return for every $1 invested, with a 71% likelihood that benefits exceed costs.
• The Strengthening Families Program (Parents and Youth 10–14) shows an estimated $5.94 return per $1 invested, with a 60% likelihood that benefits exceed costs.
• Parent-Child Interaction Therapy (PCIT) for families involved in the child welfare system has demonstrated particularly high net benefits, with an estimated $17.46 return per $1 invested and a 95% likelihood that benefits exceed costs.

Policy Options

Maximize Family First Funding Opportunities  

• States can continue expanding approved prevention services within their Family First plans.
• Redirecting funds toward prevention may reduce reliance on higher-cost foster care placements.

• Federal Family First policy provides a 50% funding reimbursement of evidence-based Title IV-E prevention and kinship navigation services [i]. Many states are not claiming all of these available resources for prevention.

Prioritize Family Strengthening Programs

• Programs focused on parenting skill building, mental health and substance use supports, align with Family First eligibility and evidence standards.
• These programs have demonstrated measurable fiscal returns in multiple cost-benefit analyses and may reduce foster care entry and re-entry.

Track Fiscal Impacts of Prevention Investments 

• Monitoring spending on prevention relative to foster care in relation to outcomes to clarify cost-effectiveness of investments over time. Family First also includes routine tracking of placement outcomes to monitor progress and impact of prevention investments.
• Clear fiscal tracking supports data-informed budgeting and continuous improvement.

Support Early, Voluntary Access to Prevention Services 

• Research highlights the importance of engaging families early, before crises escalate.
• Voluntary, community-based prevention services may increase uptake and improve cost-effectiveness.

[i] Beginning October 1, 2026, the federal reimbursement rate for Family First prevention services will shift from a flat 50% match to each state’s individual FMAP rate.

Developed with special insights from Chapin Hall scholars Yasmin Grewal-Kök, JD, and Krista Thomas, PhD.