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November 7, 2005

Join National Call-In Campaign!

National Call-In Campaign on House Budget Cuts that Include Foster Care and Medicaid

The U.S. House of Representatives is expected to vote on a budget reconciliation bill that reduces foster care funding by $600 million and cuts Medicaid funding by $12 billion during the week of November 7. Child advocates from around the country will be joining others to flood members of Congress with calls throughout the week, urging them to vote against the House budget reconciliation bill. Advocates can use a free call-in number (800-426-8073) to make these calls.


Call your U.S. Representative this week! The vote on the final passage of the House budget reconciliation bill, that includes reductions in support for abused and neglected children, is going to be close. Your U.S. Representative's vote will make a difference! You can contact your U.S. Representative in Washington, DC by calling toll-free at 800-426-8073 or by calling the U.S. Capitol switchboard at 202-225-3121.

Join advocates from across the country in a unified voice in proclaiming "No Caps on Kids!" and help us spread the message! Once you make your call, send this Legislative Alert on to others you know who care about children and families.


  • Vote NO on the House budget reconciliation bill.
The House budget reconciliation bill reduces federal foster care funding, severely limits supports for children who have been abused and neglected and are now living with grandparents or other relatives, and makes changes to Medicaid that would shift a portion of the cost to families.


This week, the House will be voting on their budget reconciliation bill that includes $600 million in cuts for foster care and supports for grandparents and other relatives caring for abused and neglected children and $12 billion in cuts to Medicaid. On November 3, the Senate approved their version of the budget reconciliation bill. The Senate bill does not include any cuts to federal funding for foster care. The bill does cut Medicaid spending, but not at the expense of health care services for Medicaid beneficiaries. The Senate bill also clarifies the use of Medicaid targeted case management for children in foster care. When the House votes on their version of the budget reconciliation bill, any differences between the House and Senate passed versions will need to be reconciled in a Senate-House conference committee.

The House budget reconciliation bill:

I. Repeals Rosales v. Thompson

Repeals a Ninth Circuit Court of Appeals ruling, Rosales v. Thompson. That decision has allowed more abused and neglected children living with relatives to receive Title IV-E federal foster care support. The bill, contrary to Rosales, establishes that a child's eligibility for federal foster care is dependent on the eligibility of the original home from which the child was removed, not the home of the relative in which the child might have subsequently been placed.

This eligibility for federal foster care support allows relatives to step in and care for abused and neglected children when needed. As a result, the nine states and two territories directly impacted by the Ninth Circuit's decision (Alaska, Arizona, California, Hawaii, Idaho, Montana, Nevada, Oregon, Washington, Guam, and the Mariana Islands) estimate that tens of thousands of additional children living with relatives are now eligible for federal foster care assistance. Ultimately, children in other states may also be affected by this ruling.

Repealing this court determination would deny federal foster care benefits to these children. In California alone, over 5,000 children would lose federal support. Legislation overturning the Rosales v. Thompson court decision would also impact some children's ability to receive federal adoption assistance, as decided by a recent court ruling in Georgia. [For more information, got the CWLA's Rosales v. Thompson website.]

II. Implements a White House Proposal to Limit Some Forms of Federal Foster Care Assistance

Another proposal in the House bill implements a White House rule initially offered in 2001--that was blocked at that time due to protests from child advocates. This proposal:
  • Reduces federal funding for services to kids living with their grandparents and other relatives by limiting Title IV-E administrative funds to support only licensed foster care placements. This represents a reversal of longstanding federal policy to encourage the placement of children with relatives whenever possible.

  • Limits federal foster care assistance for children who are at imminent risk of entering foster care. The bill reduces funding (Title IV-E administrative funding) for services to kids who are considered likely "candidates" for foster care--in other words kids who could be prevented from going into foster care.

  • Limits funding (Title IV-E administrative funding) for services to kids leaving a non-child welfare facility, such as a hospital, psychiatric center, crisis center, or juvenile facility, and being transferred into foster care.
For more information on these proposals, go to the No Caps on Kids! Campaign page.

III. Enacts Changes to Medicaid

The House bill cuts Medicaid by $12 billion over five years. The cuts accrue from increased cost-sharing, which will result in fewer low-income people receiving health care. It is predicted that new premiums and co-payments imposed on the working poor would drive millions of families out of the Medicaid system. It is estimated 6 million children will be affected by the changes.

The House bill also adopts the same language approved by the Senate on the use of Medicaid targeted case management (TCM) for children in the child welfare system.
  • The bill allows TCM to be used for: assessment of eligible individuals to determine service needs by taking a client history, identifying an individual's needs, and completing related documentation; development of a specific care plan based on the information collected through an assessment that specifies the goals and actions to address the individual's needs; referral and related activities to help an individual obtain needed services; and monitoring and follow-up activities, including activities and contacts to ensure the care plan is effectively implemented and adequately addresses the individual's needs.

  • The bill specifies that TCM benefits for children in foster care would not cover: research gathering and completion of required foster care documentation; assessing adoption placements; recruiting or interviewing potential foster parents; serving legal papers; conducting home investigations; providing transportation; administering foster care subsidies; and making placement arrangements.

  • The bill codifies the ability of states to use an approved cost allocation plan for determining the amount that can be billed as Medicaid TCM services when case management is also reimbursable by another federally funded program, such as Title IV-E Foster Care and Adoption Assistance.
The impact of these TCM provisions is being analyzed to determine whether the legislative language could be regulated in such a way as to restrict access to funding for some TCM populations and services.

For more information, visit CWLA's No Caps on Kids! Campaign website or contact Liz Meitner, CWLA Vice President of Government Affairs, at or 202-942-0257.

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