Federal Child Welfare Funding Expanding To Include Medications For Opioid Use Disorders

March 2, 2026

Starting on October 1, 2026, states will be able to use Title IV-E prevention funding to help pay for medication to treat opioid use disorder (MOUD) for parents with children at risk of entering foster care. This includes cases where children remain in the home or are in a kinship placement.

The expansion of the funds to cover buprenorphine, methadone, and naltrexone with the child welfare prevention funding is not mandatory—states have the option to expand their programs but are not required to do so.

Currently, states receive a 50% federal match from Title IV-E funding for use of MOUD. 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.

The medications are the first to be deemed “well supported” under the 2018 Family First Prevention Services Act and its new standards for prevention programs. 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 approval from the Food and Drug Administration 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.

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

A link to the full text of Dear Colleague Letter Regarding Parental Medication-Assisted Treatment For Opioid Use Disorder Coverage is in the OPEN MINDS Circle Library.

The Clearinghouse posted Procedures for Reviewing Programs and Services for the Clearinghouse for the new MOUD coverage, What is the Fast-Track Evidence Review Procedure for FDA-Approved Medications for Opioid Use Disorder (MOUD) as Part of Comprehensive Treatment Plans?, in February 2026 (accessed March 6, 2026).

For more information, contact: Teresa Reep, Acting Director of Communications, Administration for Children and Families, U.S. Department of Health and Human Services, 330 C Street Southwest, Washington, District of Columbia 20201; 202-401-9215; Fax: 202-205-9688; Email: media@acf.hhs.gov; Website: https://www.acf.hhs.gov/