[Federal Register Volume 86, Number 133 (Thursday, July 15, 2021)]
[Notices]
[Pages 37332-37334]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2021-15065]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Administration for Children and Families


Title IV-E Prevention Services Clearinghouse Handbook of 
Standards and Procedures

AGENCY: Administration for Children and Families, HHS.

ACTION: Request for public comment.

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SUMMARY: The Administration for Children and Families (ACF), within the 
U.S. Department of Health and Human Services (HHS), established the 
Title IV-E Prevention Services Clearinghouse (hereafter, the 
Clearinghouse; https://preventionservices.abtsites.com). This Federal 
Register Notice (FRN) seeks comments by August 16, 2021 on the 
Clearinghouse's Handbook of Standards and Procedures, Version 1.0. 
Responses to this FRN will inform potential updates and clarifications 
to existing standards and procedures. Readers are referred to the full 
version of the

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Handbook of Standards and Procedures, Version 1.0 on the Clearinghouse 
website (https://preventionservices.abtsites.com/review-process). 
Specifically, feedback is invited on each of the steps and operational 
procedures of the Prevention Services Clearinghouse systematic review 
process.

DATES: The deadline for comments on this notice is August 16, 2021.

ADDRESSES:  Interested parties may submit written questions, comments, 
and supplementary documents by email to [email protected] 
with ``Title IV-E PSC FRN comment'' in the subject line. To ensure that 
your comments have maximum effect, please identify clearly the section 
of the Handbook of Standards and Procedures, Version 1.0 (https://preventionservices.abtsites.com/review-process) that your comment 
addresses.

SUPPLEMENTARY INFORMATION:

1.0 Background and Legislative Context

    The Family First Prevention Services Act (FFPSA) was signed into 
law as part of the Bipartisan Budget Act (H.R. 1892) on February 9, 
2018. FFPSA amended the Social Security Act (the Act) to enable use of 
Federal funds available under parts B and E of title IV of the Social 
Security Act to provide enhanced support to children and families and 
prevent foster care placements through the provision of evidence-based 
mental health and substance abuse prevention and treatment services, 
in-home parent skill-based programs, and kinship navigator services. As 
described in the statutory language, these services and programs are 
intended ``for children who are candidates for foster care or who are 
pregnant or parenting foster youth and the parents or kin caregivers of 
the children.''
    The Act requires an independent systematic review of evidence to 
designate programs and services as ``promising,'' ``supported,'' and 
``well supported'' practices, defined as follows in section 
471(e)(4)(C):
     Promising Practice: ``A practice shall be considered to be 
a `promising practice' if 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 parent outcomes, such as 
mental health, substance abuse, and child safety and well-being), as 
established by the results or outcomes of at least one study that--(1) 
was rated by an independent systematic review for the quality of the 
study design and execution and determined to be well-designed and well-
executed; and (2) utilized some form of control (such as an untreated 
group, a placebo group, or a wait list study).''
     Supported Practice: ``A practice 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 parent 
outcomes, such as mental health, substance abuse, and child safety and 
well-being), as established by the results or outcomes of at least one 
study that--(aa) was rated by an independent systematic review for the 
quality of the study design and execution and determined to be well-
designed and well-executed; (bb) was a rigorous random-controlled trial 
(or, if not available, a study using a rigorous 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 treatment.''
     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 meaningful 
improvements in validated measures of important child and parent 
outcomes, such as mental health, substance abuse, and child safety and 
well-being), as established by the results or outcomes of at least two 
studies that--(aa) were rated by an independent systematic review for 
the quality of the study design and execution and determined to be 
well-designed and well-executed; and (bb) were rigorous random-
controlled trials (or, if not available, studies using a rigorous 
quasi-experimental research design); and (cc) were carried out in a 
usual care or practice setting; and (II) at least one of the studies 
described in sub-clause (I) established that the practice has a 
sustained effect (when compared to a control group) for at least 1 year 
beyond the end of treatment.''
    In accordance with the statute, practices must also meet the 
following requirements:
     Book or manual: 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.
     No empirical risk of harm: There is no empirical basis 
suggesting that, compared to its likely benefits, the practice 
constitutes a risk of harm to those receiving it.
     Weight of evidence supports benefits: If multiple outcome 
studies have been conducted, the overall weight of evidence supports 
the benefits of the practice.
     Reliable and valid outcome measures: Outcome measures are 
reliable and valid, and are administrated consistently and accurately 
across all those receiving the practice.
     No case data for severe or frequent risk of harm: There is 
no case data suggesting a risk of harm that was probably caused by the 
treatment and that was severe or frequent (section 471(e)(4)(C)(ii) of 
the Act).
    In order to meet these requirements, ACF established the 
Clearinghouse. The Clearinghouse carries out a systematic review 
process implemented by trained reviewers using consistent, transparent 
standards and procedures. The Handbook of Standards and Procedures, 
Version 1.0 (https://preventionservices.abtsites.com/review-process) 
provides a detailed description of the standards used to identify and 
review programs and services for the Clearinghouse and the procedures 
followed by the Clearinghouse staff. The Handbook of Standards and 
Procedures, Version 1.0 was informed by public comments submitted in 
response to Federal Register Notice 83 FR 29122 (https://www.federalregister.gov/documents/2018/06/22/2018-13420/decisions-related-to-the-development-of-a-clearinghouse-of-evidence-based-practices-in-accordance), consultations with research and practice 
experts, and the review processes developed and used by other prominent 
evidence clearinghouses.

2.0 Request for Information (RFI)

    Through this FRN, ACF invites feedback on the Handbook of Standards 
and Procedures, Version 1.0 (https://preventionservices.abtsites.com/review-process). Specifically, feedback is invited on each of the steps 
of the Prevention Services Clearinghouse systematic review process:
    1. Identify programs and services for review. Candidate programs 
and services relevant to the mission of the Clearinghouse are 
identified using an inclusive process that invites recommendations from 
stakeholders, including states, to ensure broad coverage across program 
or service areas (Chapter 1).
    2. Select and prioritize programs and services for review. 
Candidate programs

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and services are evaluated against the program or service eligibility 
criteria and prioritized for review (Chapter 2).
    3. Literature search. Clearinghouse staff conduct comprehensive 
literature searches to locate available and relevant research on the 
prioritized programs and services (Chapter 3).
    4. Study eligibility screening and prioritization. Studies 
identified in the literature searches are screened against the study 
eligibility criteria. Studies determined to be eligible for review are 
considered against prioritization criteria to determine the order and 
depth of their review (Chapter 4).
    5. Evidence review. All eligible studies are reviewed by trained 
reviewers using the Clearinghouse design and execution standards. Study 
authors may be queried to request information deemed necessary to 
assign a rating. One of three ratings is assigned to prioritized 
studies: High, moderate, or low support of causal evidence (Chapter 5).
    6. Program and service ratings. Studies that are rated as high or 
moderate support of causal evidence are considered in assigning each 
program or service one of four ratings: Well-supported, supported, 
promising, or does not currently meet criteria (Chapter 6). These 
ratings also take into consideration any evidence of risk of harm.
    Feedback is also invited on the operational procedures for 
reviewing programs and services (Chapter 7).
    Responses to this FRN will inform ongoing discussion about 
potential updates and clarifications to existing standards and 
procedures. Consistent with the practice of other prominent federal 
evidence reviews, standards and procedures may be revised over time as 
research methods evolve, the needs of the field change, and lessons are 
learned during the review process. Potential revisions to the 
Clearinghouse's standards and procedures may affect which programs and 
services are eligible or prioritized for review, which studies of 
programs and services are eligible or prioritized for review, which 
studies of programs and services meet design and execution ratings, and 
program or service ratings. ACF especially welcomes comments on how the 
standards and procedures might be revised to better reflect the goals 
and requirements of the Executive Order on Advancing Racial Equity and 
Support for Underserved Communities Through the Federal Government 
(https://www.whitehouse.gov/briefing-room/presidential-actions/2021/01/20/executive-order-advancing-racial-equity-and-support-for-underserved-communities-through-the-federal-government/) and the President's 
Memorandum on Restoring Trust in Government Through Scientific 
Integrity and Evidence-Based Policymaking (https://www.whitehouse.gov/briefing-room/presidential-actions/2021/01/27/memorandum-on-restoring-trust-in-government-through-scientific-integrity-and-evidence-based-policymaking/).
    Through this FRN, ACF is soliciting information from a broad array 
of stakeholders. This FRN is one way to ensure that activities 
associated with the Title IV-E Prevention Services Clearinghouse are 
transparent and build from the existing knowledge of states, federal 
agencies, researchers, evaluators, program and service developers, key 
stakeholders and experts, and the general public. The public will have 
an opportunity to comment on specific revisions to the Clearinghouse's 
standards and procedures through a future FRN.
    To facilitate the review of submissions, please identify the 
chapter, section, and/or page number of the Handbook of Standards and 
Procedures, Version 1.0 (https://preventionservices.abtsites.com/review-process) that your comments address.
    This RFI is for information and planning purposes only and should 
not be construed as a solicitation or as an obligation on the part of 
ACF or HHS.
    For more information about the Prevention Services Clearinghouse, 
visit: https://preventionservices.abtsites.com.

Naomi Goldstein,
Deputy Assistant Secretary for Planning, Research, and Evaluation.
[FR Doc. 2021-15065 Filed 7-14-21; 8:45 am]
BILLING CODE 4184-01-P