ACF Expands Access to Medications for Opioid Use Disorder for At-Risk Families

The U.S. Department of Health and Human Services through its Administration for Children and Families (ACF) today announced that three U.S. Food and Drug Administration-approved Medications for Opioid Use Disorder (MOUD) have been added as prevention services eligible for funding under Title IV-E, which supports children and families involved with the child welfare system.

States and tribes can now receive a 50 percent federal match to provide buprenorphine, methadone, and naltrexone to parents when children are at imminent risk of entering foster care but can remain safely in the home or in a kinship placement with access to these treatments. Following President Trump's new Executive Order, Addressing Addiction Through the Great American Recovery Initiative , this expansion gives states new resources to address the opioid crisis, stabilize families, and prevent entries into foster care.

For each MOUD to meet the "well-supported" evidence standard in the Title IV-E Prevention Services Clearinghouse, ACF developed a new Fast-Track Evidence Review Procedure that leverages the FDA's rigorous approval and post-market surveillance to accelerate clearance without compromising safety standards. This streamlined approach eliminates duplicative review steps that have historically delayed families' access to lifesaving treatment.

"When we deny parents access to affordable, effective treatment for opioid addiction, we tear families apart," said Health and Human Services Secretary Robert F. Kennedy, Jr. "Using Title IV-E funding to provide life-saving medications keeps families together and moves our system toward recovery and prevention."

ACF's funding support of MOUD is part of President Trump's new Great American Recovery Initiative co-chaired by Secretary Kennedy. It reflects President Trump's vision that "the best foster care system is one that is not needed in the first place" and supports Secretary Kennedy's mission to advance a comprehensive, prevention-focused response to the opioid crisis. All three FDA-approved MOUD are well-established, evidence-based tools that support recovery, promote family stability, and reduce risk factors associated with child welfare system involvement.

"At the Administration for Children and Families, we are cutting through the red tape that has kept effective opioid use disorder treatment out of reach for too many families," saidAssistant Secretary for Family SupportAlex J. Adams. "By fast-tracking these proven treatments, we are investing in effective prevention to give states powerful new tools to help keep families safely together."

Expanding Title IV-E eligibility to include MOUD directly advances ACF's A Home for Every Child initiative , which aims to achieve a nationwide foster home-to-child ratio greater than 1:1. To achieve this goal, states can both increase the number of safe, available foster homes while simultaneously reducing foster care entries through effective prevention services. With parental substance use disorder ranking among the leading causes of foster care placement, expanding state access to MOUD represents a targeted prevention approach that addresses the root cause.

"These medications represent the gold standard in evidence-based care for opioid use disorder," said Christopher D. Carroll, Principal Deputy Assistant Secretary of the Substance Abuse and Mental Health Services Administration (SAMHSA). "By making these treatments available through Title IV-E prevention funding, we are now ensuring that more families can access the comprehensive care they need to recover and stay together."

To support rapid implementation, interested states, tribes, and territories can access sample program language and requirements through ACF's Children's Bureau. Technical assistance is also available through the National Child Welfare Center on Innovation and Advancement and the National Center on Substance Abuse and Child Welfare.

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