The U.S. Department of Health and Human Services has added two peer-support interventions to the federal Title IV-E Prevention Services Clearinghouse, allowing states to seek federal reimbursement for eligible use of the programs.
The new additions are Family-Based Recovery – Supported and Wellness Recovery Action Plan (WRAP) – Supported. Both received a supported evidence rating from the Administration for Children and Families.
The decision expands the federal options available to states seeking to address parental substance use and other challenges before they result in children entering foster care.
Iowa Becomes First State to Adopt a New Program
Iowa is the first state to adopt one of the newly added peer-support interventions.
The state has already updated its prevention plan using model language provided by ACF, allowing it to incorporate an evidence-rated peer-support approach into its Title IV-E prevention strategy.
ACF said other states can now follow the same route by updating their prevention plans to include eligible services.
What the Two Programs Provide
Family-Based Recovery – Supported is an intensive, in-home clinical program for parents of children aged 0 to 5 who are affected by addiction.
The program combines clinical treatment with a weekly peer-support meeting while supporting children remaining in a safe and stable home with their parents.
WRAP – Supported takes a different approach. It is a facilitated peer-group program led by trained peer facilitators.
Participants work through recovery concepts and develop strategies to respond to and recover from crises involving mental health and addiction.
The two programs join Sobriety Treatment and Recovery Teams (START) and Parents Anonymous, which were already listed in the Clearinghouse with a Supported rating.
Substance Use Is a Major Foster-Care Concern
The expansion comes as federal child-welfare data show a strong connection between parental substance use and children’s removal from their homes.
In 2024, parental alcohol or other drug abuse was reported as a removal circumstance for 38.2% of children entering out-of-home care. For children younger than one, the figure reached 55.2%.
The pattern has also changed substantially over time. NCSACW data show parental alcohol or drug abuse was associated with the removal of 27.8% of infants in 2000, compared with about 55% in 2025.
That makes early support for parents particularly relevant to prevention efforts involving infants and young children.
Federal Reimbursement Rules Are Also Changing
The new programs are being added as the financing framework for Title IV-E prevention services is changing.
Under the Family First Prevention Services Act, eligible evidence-based prevention services can receive federal funding when states meet program and plan requirements.
The federal reimbursement rate has generally been 50%, but beginning in October 2026, the rate is scheduled to transition to the applicable Federal Medical Assistance Percentage (FMAP) for each state or tribe.
The change could affect how much federal funding states receive for qualifying prevention services.
More Than 200 Programs Have Been Reviewed
The new additions are part of a broader federal evidence-review process rather than a standalone initiative.
As of June 2026, the Title IV-E Prevention Services Clearinghouse had reviewed 222 programs and services. 102 had received one of the positive ratings of promising, supported, or well-supported.
A program’s inclusion and rating determine whether it can qualify for Title IV-E prevention funding, subject to the applicable federal and state requirements.
ACF Is Looking for More Peer-Support Programs
ACF is also opening the door to additional interventions.
The agency’s Office of Planning, Research, and Evaluation has issued a public call for recommendations of peer-support programs and services that could be systematically reviewed for possible future inclusion in the Clearinghouse.
The latest move therefore gives states two additional evidence-rated options, while signaling that HHS wants peer support to play a larger role in prevention efforts aimed at helping families affected by addiction remain together.
