Last updated: November 2026
The Title IV-E Prevention Services Clearinghouse is the federal review that rates child and family programs well-supported, supported or promising under the Family First Prevention Services Act. A state title IV-E agency can claim reimbursement for mental health and substance use prevention and treatment services provided by qualified clinicians, and for in-home parent skill-based programs, that are rated and approved by the Clearinghouse and identified in the state's five-year prevention plan (Program Instruction ACF-ACYF-CB-PI-24-10, opened 2026-11-05). Integral Healthcare Solutions (IHS) is a consulting firm, not a law firm; it drafts the manual, implementation supports and evidence record for your leaders to approve, cannot produce the research a rating rests on, and gives no legal advice.
What is the Title IV-E Prevention Services Clearinghouse?
It is a review body the Administration for Children and Families (ACF), within the U.S. Department of Health and Human Services, established to review research on programs and services intended to provide enhanced support to children and families and prevent foster care placements (Clearinghouse home page, opened 2026-11-05). It reviews programs under the Handbook of Standards and Procedures, Version 2.0. As of September 2026 it had reviewed 225 programs and services, and 105 of them were rated promising, supported or well-supported. As of December 2025, the ACF Assistant Secretary has final approval of ratings (Clearinghouse FAQ, opened 2026-11-05).
What does each Clearinghouse rating require?
Each rating depends on contrasts, meaning comparisons between a group that received the program and a comparison group, in randomized controlled trials (RCTs) or quasi-experimental designs (QEDs). A favorable effect is one in the desired direction that is statistically significant. A program also cannot earn any of the three ratings if it fails the risk of harm standards (Handbook Section 7.2.1). The table summarizes Handbook Section 7.1 as opened 2026-11-05.
| Rating | What the Handbook requires |
|---|---|
| Well-supported | At least two contrasts with non-overlapping samples, in RCT or QED studies carried out in usual care or practice settings, each rated high or moderate on design and execution with favorable effects in a target outcome domain. At least one contrast must show a sustained favorable effect of at least 12 months beyond the end of treatment on at least one eligible outcome. |
| Supported | At least one contrast in an RCT or QED study carried out in a usual care or practice setting, rated high or moderate on design and execution, with a sustained favorable effect of at least 6 months beyond the end of treatment on at least one eligible outcome. |
| Promising | At least one contrast in a study that uses some form of control, rated high or moderate on design and execution, with a favorable effect on at least one eligible outcome. |
| Does not currently meet criteria | A reviewed program that earns none of the three ratings, including one with no eligible studies or one that fails the risk of harm standards. |
A usual care or practice setting is an existing service agency or provider that delivers these services as part of its typical operations; a clinic set up only for a research study does not count (Handbook Section 7.2.2).
How does a program get reviewed?
The Clearinghouse chooses what to review and invites public recommendations. A recommendation can be emailed at any time (page opened 2026-11-05) and should be for an eligible program the Clearinghouse has not previously reviewed. The October 2026 public call is closed, but the Clearinghouse says it logs and considers every recommendation. It cannot say when a program will be prioritized.
To be eligible, a program must fall in one of four areas: mental health prevention and treatment, substance use prevention and treatment, in-home parent skill-based programs, or kinship navigator programs. It must also have a written or recorded manual that specifies the components of the practice and describes how to implement it, with documented evidence that the public can download, request or purchase it. If, after gathering information, the Clearinghouse still lacks enough to define a program's content, dosage, modality, providers or other key components and apply its adaptation procedures, it lists the program as not eligible for review at this time (Handbook Section 2.1.2).
In choosing programs the Clearinghouse weighs eligibility evidence, active use, recommendations received, child welfare relevance, populations served, earlier evaluations and implementation supports. It gives particular consideration to recommendations from state, tribal or local government child welfare administrators and federal partners (Handbook Section 2.2.3).
Who needs Clearinghouse readiness work, and what triggers it?
- A developer or provider that owns a manualized program in one of the four areas and wants it rated so state agencies can fund it.
- An owner whose program is on the planned-for-review list (opened 2026-11-05). The Clearinghouse calls that a working list, and a listed program can later be found ineligible.
- An owner whose program was rated “does not currently meet criteria,” or has new studies since its review, and wants a re-review request assembled.
- A provider that delivers a rated program with changes. The Clearinghouse treats a substantially adapted version as a separate program for review, and a study of a substantially adapted version is not eligible for the original program.
How does IHS help with Clearinghouse readiness?
This is program development work, one of three IHS practice lines. Thomas G. Goddard, JD, PhD, leads the work. The process:
- Gap assessment of your materials against Handbook Chapter 2: program area, manual availability, and defined content, dosage, modality and providers.
- Drafting or revising the manual, fidelity checklist and training outline for your leaders to approve.
- An adaptation log across manual editions and variants.
- An evidence map that checks each study against the Handbook's eligibility rules and the stated reasons for a low design and execution rating, with gaps marked for your evaluator.
- A draft recommendation message and program description for your organization to send to the Clearinghouse.
- A mock review: a reviewer-style read of the whole package, a findings list and drafted corrections.
You supply the program design, the studies and data, clinical sign-off on every clinical document, the named contact who answers Clearinghouse queries, and an evaluator. Your organization sends every message to the Clearinghouse.
The limit. IHS cannot create evidence, run or write up a study, or influence a rating. If no eligible study with a comparison condition exists, that is a study design question for your evaluator, and the Clearinghouse's brief on designing quasi-experimental studies (December 2024; page opened 2026-11-05) is a place to start.
What should a program have ready?
Each item follows from the Handbook or the Clearinghouse FAQ, both opened 2026-11-05.
- The manual, written or recorded, with its components and implementation steps, and proof the public can download, request or purchase it (Handbook 2.1.2). Training or certification prerequisites are acceptable if the Clearinghouse can verify the manual and public access.
- The program area it fits among the four, and a plain description of its content, dosage, modality and providers (2.1.1 and 2.1.2).
- A written history of manual editions and variants, with each adaptation noted.
- Implementation supports such as fidelity checklists, supervision, videos, training and coaching, with documented evidence they are available to the public free or for purchase (2.2.3).
- Evidence of active use, the population served and child welfare relevance (2.2).
- A list of every RCT or QED study of the current program version, with citations and full reports, noting the comparison condition and the outcome measured.
- For each study, baseline equivalence tables, missing data handling and the statistical model. The Handbook rates a contrast low when the baseline effect size is above 0.25, and applies that test to QEDs and to RCTs with compromised randomization or high attrition (5.7).
- For each study, the usual care setting and the time from end of treatment to follow-up measurement (7.2.2 and 7.2.3).
- A developer contact on your website and a named person who answers Clearinghouse queries promptly.
To have us compare your materials with this list, schedule the free introductory call.
How does a Clearinghouse rating compare with other credentials?
The Clearinghouse rates a program from research. Accreditation and licensing apply to an organization's operations, a separate question. Our CARF residential treatment for youth page covers one organization-level example.
The California Evidence-Based Clearinghouse for Child Welfare (CEBC) is a different review. The Clearinghouse FAQ (opened 2026-11-05) says the Clearinghouse is required to conduct an independent, systematic evidence review and, unlike CEBC, lets rigorous quasi-experimental evidence earn a well-supported or supported rating. We do not tell you which to pursue.
What does Clearinghouse readiness cost?
The Clearinghouse pages we opened do not mention a fee for recommending a program or for a review. Verify current fees with the Clearinghouse. IHS scopes each engagement after a free introductory call.
What this is not
- It is not a way to buy a rating. IHS does not produce evidence.
- It is not legal advice. Funding and claiming questions go to your counsel and your state agency.
- It is not liaison work. Your organization sends recommendations and re-review requests; IHS does not submit them or contact the Clearinghouse.
Frequently asked questions
What is the Title IV-E Prevention Services Clearinghouse?
It is the federal review, set up by the Administration for Children and Families, that rates programs and services for children and families from the research on them. State title IV-E agencies use the ratings in their Family First prevention plans.
What ratings can a program receive?
Well-supported, supported, promising, or does not currently meet criteria. Under Handbook Version 2.0, each of the first three needs studies rated high or moderate on design and execution with favorable effects. Supported adds a sustained favorable effect of at least 6 months beyond the end of treatment, and well-supported adds two non-overlapping contrasts and a sustained effect of at least 12 months beyond the end of treatment.
How does a program get reviewed?
The Clearinghouse selects programs and invites public recommendations by email at any time; only the program name is required, and a recommendation should be for an eligible program not previously reviewed. The Clearinghouse logs every recommendation and cannot tell a submitter when a program will be prioritized.
Which studies count toward a rating?
A study must use a randomized controlled trial or quasi-experimental design with a comparison condition, evaluate the current version of the program, measure at least one eligible outcome, be publicly available in English and be published or prepared in or after 1990.
How long does a review take?
The Clearinghouse says the timeline for an individual program is difficult to predict. Factors include, but are not limited to, how quickly developers and study authors answer queries, how many eligible studies exist, and whether expert consultation is needed.
Can a consultant get my program rated?
No. A rating follows from the studies that exist and how the Handbook scores their design and execution. A consultant can organize the manual, implementation supports and evidence record, and IHS does that work. IHS cannot produce evidence, run an evaluation or change a rating.
How does a rating connect to Family First prevention funding?
Program Instruction ACF-ACYF-CB-PI-24-10 says a state title IV-E agency can claim reimbursement for mental health and substance use prevention and treatment services provided by qualified clinicians, and in-home parent skill-based programs, that are rated and approved by the Clearinghouse and identified in the state's five-year prevention plan. From FY 2024 on, at least 50 percent of the funds a state spends on prevention services in a fiscal year must be for well-supported services.
What if my program was rated “does not currently meet criteria,” or I have new studies?
The Clearinghouse may re-review a program for missing information or errors in the original review, or when substantial new evidence could change the rating. Requests should be emailed with the rationale and supporting documentation, such as citations for new studies. There is no limit on the number of re-reviews.