The Trump administration just handed expectant parents access to 100 federally-funded services designed to keep families together and children out of foster care.
The Department of Health and Human Services announced Tuesday that unborn children are now considered “candidates for foster care” — a designation that unlocks mental health treatment, substance abuse counseling, home visiting programs, and parenting services for pregnant mothers before the baby arrives.
The move builds on the Family First Prevention Services Act, which previously reserved federal prevention funds for families with children already at risk of foster placement. Now, expectant parents qualify before birth.
The Family First Prevention Services Act, enacted in 2018 with bipartisan support, represented a major shift in how the federal government approaches child welfare. Rather than simply funding foster placements after family breakdowns occur, the law authorized federal dollars to flow toward keeping families intact through early intervention. Until now, however, that intervention could only begin after a child was born and identified as being at imminent risk of removal from the home. The new policy removes that timing restriction, allowing services to begin during pregnancy when warning signs emerge.
“He said the best foster care system is the one that is not needed in the first place. This is designed to protect that family, stabilize that family, keep that child safe, so that foster care is not needed in the first place.”
Alex J. Adams, Assistant Secretary for the Administration for Children and Families at HHS, said the policy realizes Trump’s vision of transforming the foster care system by preventing entries at the earliest possible moment.
The timing matters: one in five children entering foster care is under the age of one. A bipartisan group of 29 states had repeatedly asked the federal government to extend prevention services to pregnant mothers whose children might be at risk.
That statistic underscores a fundamental challenge in child welfare: by the time infants enter the system, families are often in crisis and intervention becomes far more difficult and costly. State child welfare agencies have long recognized that prenatal periods offer crucial windows for stabilizing at-risk households, but federal funding restrictions prevented them from deploying prevention services until after birth. The requests from 29 states reflected growing frustration with this gap, as caseworkers watched preventable situations deteriorate during pregnancy simply because federal reimbursement rules prohibited earlier action.
Adams told The Daily Wire that “about 100 different services” qualify for prevention funding under the Title IV-E Prevention Services Clearinghouse — everything from medications for opioid use disorder to in-home parenting coaching.
States receive federal reimbursement for providing these services, which include supports not typically covered by Medicaid. The services are available regardless of income level.
The distinction from Medicaid is significant. While Medicaid covers traditional medical care during pregnancy, it often excludes the intensive behavioral health and family support services that address the root causes of foster placements. Services like cognitive behavioral therapy for parents, trauma-informed parenting programs, and recovery support for substance use disorders have proven effective at preventing family separations but historically required state-only funding when provided prenatally. The new policy shifts a substantial portion of those costs to federal reimbursement, potentially expanding access considerably.
Dr. Stephanie Haridopolos, Director of National Health Communications for the Office of the Surgeon General, said stable environments and healthy routines during pregnancy are critical for long-term child well-being.
“This program is one of the best ways we can support unborn children and their expectant parents by preparing them before their baby even arrives.”
Adams explained that pregnancy is “one of those critical moments” where targeted services can prevent foster placements entirely. The administration believes early access to mental health and substance abuse treatment will encourage parents to keep children they might otherwise surrender to the system.
The policy’s focus on substance abuse treatment reflects national trends in foster placements. Parental drug use, particularly opioid addiction, has become a leading driver of child removals over the past decade. By providing access to medications for opioid use disorder and counseling services during pregnancy, the administration is targeting one of the most common reasons infants are removed from their mothers immediately after birth. Child welfare experts have long argued that treating maternal addiction as a medical condition rather than solely a child safety issue produces better outcomes for both mothers and babies.
The policy took effect this week and applies nationwide.
