March 2, 2026

States will be able to use Title IV-E prevention funding to help pay for medication to treat opioid use disorder (MOUD) as a “well-supported” preventive intervention for parents with opioid use disorder (OUD) of children at imminent risk of entering foster care. The funds can be used in cases where children remain in the home, or in a kinship placement.

States that add MOUD to their Title IV-E prevention plans are eligible for a 50% federal match. Beginning October 1, 2026, the federal reimbursement rate for Title IV-E prevention services will increase to align with each state’s Medicaid federal matching rate.

MOUD is now designated as “well-supported” in the Title IV-E Prevention Services Clearinghouse, according to the Administration for Children and Families (ACF) announcement. For each MOUD to meet the “well-supported” evidence standard in the Title IV-E Prevention Services Clearinghouse, ACF developed a Fast-Track Evidence Review Procedure that leverages FDA approval and post-market data to expedite review for Clearinghouse designation.

The new option was announced on February 2, 2026, accompanied by release of a Dear Colleague letter, which noted that national survey data indicate that only a small fraction of people with OUD receive MOUD. The treatment gap results in untreated OUD and increased risk of fatal overdose, justice involvement, education disruption, mental health deterioration, and family separation that often results in foster care placement.

ACF emphasized that while MOUD is key to evidence-based OUD treatment, effective care requires a comprehensive, person-centered approach that addresses the full spectrum of developmental, behavioral, and social needs. Optimal treatment integrates MOUD with psychosocial interventions in a multimodal, wraparound approach that includes individual and family therapy, peer support, case management, and connections to educational and vocational services.

ACF encouraged states to prepare to ensure that people with OUD can access MOUD promptly. The preparation may include training child welfare workers and juvenile justice staff to recognize OUD and facilitate connections to treatment, educating judges and attorneys about the evidence base for MOUD, expanding the network of providers who can prescribe buprenorphine, ensuring coverage of all three FDA-approved medications without prior authorization or unnecessary administrative barriers, and developing policies that support rather than penalize those who are engaged in MOUD treatment.

The announcement ACF Expands Access to Medications for Opioid Use Disorder for At-Risk Families was released February 2, 2026 (accessed February 12, 2026).