Children's Monitor Online
A Public Policy Update from the Child Welfare League of America

   
   
Vol. 20, Issue 18: 5/7/2007   
Headlines

CWLA Launches Care About Kinship Campaign

Head Start on Track For Reauthorization with House Endorsement

Bipartisan SCHIP Reauthorization Bill Introduced

Subcommittee Holds Third Poverty Hearing

Kennedy and Ramstad Present Mental Health Parity Report to Speaker

GAO Report Raises Concerns About Oversight of Children's Dental Services

CWLA Legislative Alerts Available to Subscribers

Key Upcoming Dates for Congress



CWLA Launches Care About Kinship Campaign

CWLA this week launches the Care About Kinship campaign to build support for the Kinship Caregiver Support Act. The Senate bill (S. 661) was reintroduced by Senators Hillary Clinton (D-NY) and Olympia Snowe (R-ME) in February. We anticipate the House companion bill will be reintroduced by Representatives Danny Davis (D-IL) and Tim Johnson (R-IL) at the end of this week.

In the spirit of Mother's Day, we are urging Members of Congress to cosponsor the legislation. We are launching this effort by encouraging members of CWLA to contact their House and Senate members to cosponsor the Kinship Caregiver Support Act. Additionally, CWLA and several other organizations will convene a Capitol Hill briefing on May 11 entitled, "Children Being Raised by Grandparents and Other Relatives: How Are They Faring?" Generations United and Kids Are Waiting, in collaboration with Representatives Davis and Johnson, are sponsoring the briefing.

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Head Start on Track For Reauthorization with House Endorsement

On May 2 the House of Representatives passed H.R. 1429 to reauthorize the Head Start program. The overwhelming 365-48 vote increases the likelihood that Head Start will be reauthorized this year after stalling out since its reauthorization expired in 2003.

The U.S. House of Representatives approved a Head Start reauthorization bill that year that contained a controversial proposal, introduced by the White House, to allow up to eight states to receive Head Start funding as a block grant instead of the current structure that provides dollars directly to local Head Start programs. The controversy over the proposed block grant created a contentious debate, and the House passed that bill by a one-vote margin, 217-216.

CWLA had joined several other Head Start supporters in opposing that proposal and another earlier Administration proposal to transfer Head Start from the Department of Health and Human Services to the Department of Education. Both of those proposals now appear to be dead. The Senate, which has not held a floor debate on Head Start since 2003, may take up its bill (S. 556) before the Memorial Day break. The Senate has never supported a block grant for Head Start.

Both bills also reject an Administration effort to conduct testing of Head Start students. Testing under the National Reporting System (NRS) was piloted by the Administration and drew objections from many groups, including CWLA, on the basis of how the testing was being implemented and the effect it was having on the 4- and 5-year-olds being tested. Both the House and Senate bills stop the NRS.

The House Head Start bill authorizes Head Start funding at $7.4 billion in 2008, an increase of more than $600 million over the 2007 funding level. CWLA has requested a $750 million increase to adjust for the effect of near level funding over the past five years.

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Bipartisan SCHIP Reauthorization Bill Introduced

After much anticipation, Senators John Rockefeller (D-WV), Olympia Snowe (R-ME), and Edward Kennedy (D-MA) have introduced the Children's Health Insurance Program Reauthorization Act of 2007 (S. 1224). This legislation would more than double federal resources available over the next five years for health coverage for children through the State Children's Health Insurance Program (SCHIP) so states can maintain current enrollees and reach out to cover as many of the 6 million eligible but unenrolled children as possible.

To assist with enrolling more eligible children, under S. 1224, states could use financial information gained from other means-tested programs, such as WIC or school lunches, to determine whether children are income-eligible for CHIP (so-called express lane eligibility). Discretion would be returned to the states to decide the best way for eligible individuals to establish their citizenship or nationality. A 75% administrative match rate would be provided to states that make significant strides to enroll disproportionately underrepresented populations, such as legal immigrant and minority children, by offering eligibility and enrollment services in various languages.

SCHIP would remain a capped funding program, but S. 1224 guarantees greater federal financial commitment and works to better the current funding formula and more uniquely tailor state-specific allotments. Each state's annual allotment, which would be recalculated every two years to stay accurate, would be based on both the state's spending in FY 2007 (taking into account health care inflation and population growth) and the state's share of uninsured low-income children, while also incorporating a geographic cost adjustment.

To encourage efficient and timely use of funds, S. 1224 shortens how long a state may hold onto its allotment, from three years to two. Any remaining funds after two years would be placed into a pool that eventually would be redistributed to states that are more actively enrolling target populations. S. 1224 would give states the option to cover children up to 300% federal poverty level, legal immigrant children, and pregnant women. The overall health care package would also be strengthened, guaranteeing dental and increasing standards to ensure mental health coverage.

The bill includes several provisions supported by child advocates and many states. A recent survey by the Georgetown University Health Policy Institute's Center on Children and Families, entitled "Children's Health Coverage: States Moving Forward," found a diverse group of states have taken various strides with their SCHIP programs. Many states are engaging in more outreach and enrollment simplification initiatives and since January 2006. Twenty-nine states and the District of Columbia have already adopted or are seriously considering legislation aimed at covering more children through SCHIP—in many cases by increasing SCHIP income eligibility levels to more than 200% of the federal poverty level (FPL).

The Bush Administration, however, has signaled different desires in terms of any potential SCHIP reauthorization. Hoping for SCHIP to be redirected toward its original target of low-income uninsured children, it would prefer the FPL eligibility level to remain at 200% and no new adults to be encompassed. Health and Human Services Secretary Michael Leavitt has summed up that "the solution isn't to incrementally hook one more car to the train of government-run health care."

Rockefeller and Snowe both serve on the Senate Finance Committee, which has jurisdiction over SCHIP reauthorization. Congressional aides have said the committee hopes to report out the SCHIP reauthorization legislation in late spring.

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Subcommittee Holds Third Poverty Hearing

On April 26, the House Ways and Means Subcommittee on Income Security and Family Support, chaired by Representative Jim McDermott (D-WA), held its third hearing on poverty since the 110th Congress began. During the hearing, panelists representing public and private service providers and research centers presented proposals for reducing poverty. Witnesses included John Podesta, President, Center for American Progress; Linda Gibbs, Deputy Mayor for Health and Human Services, City of New York; Reverend Larry Snyder, President, Catholic Charities USA; Gordon Berlin, President/CEO, Manpower Demonstration Research Corporation; Isabel Sawhill, Senior Fellow, The Brookings Institution; and Lawrence Mead, Professor of Politics, New York University.

Although poverty reduction proposals presented at the hearing had similar goals, some strategies were quite diverse. Two key themes were personal responsibility and government responsibility. Most panelists agreed the two work hand-in-hand; nevertheless, some argued it could be either-or in reaching the goal of diminishing poverty.

Such ideological perspectives were apparent throughout the hearing. For example, Sawhill concurred that individuals must get a good job, not have children before marriage, and work full-time. At the same time, she believes governments must reward individuals once these things are achieved. Mead expressed support for increasing the minimum wage. Simultaneously, he mentioned that work hours and the work participation rate must be increased, with particular attention on men--particularly, those on parole and who owe back child support.

CWLA applauds the subcommittee for holding this hearing on poverty. We hope Congress will once again seriously confront the challenge and the need to reduce poverty and improve the lives of children and families throughout the United States.

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Kennedy and Ramstad Present Mental Health Parity Report to Speaker

After traveling the country on their "Campaign to Ensure Mental Health and Addiction Equity" for the past three months, Representatives Patrick Kennedy (D-RI) and Jim Ramstad (R-MN) presented a summary of findings to House Speaker Nancy Pelosi (D-CA) and other key House leaders at a May 2 press conference.

Kennedy and Ramstad introduced the Paul Wellstone Mental Health and Addiction Equity Act (H.R. 1424) in March and since then have garnered 265 bipartisan cosponsors. The bill would require group health plans of fifty individuals or more that choose to offer benefits for mental health and addiction to do so on the same terms of care as other diseases. GAO estimates some 90% of plans impose financial limitations and mental health and addiction treatment restrictions. Members of Congress at the press conference estimated this caused about 300,000 individuals to be denied treatment last year alone. Pelosi reminded the crowd that, should parity legislation pass, children could be spared trauma that otherwise would ensue.

Kennedy and Ramstad listened to everyday Americans in 14 cities and towns share their personal stories and struggles with mental illness and addiction, and compiled these moving sentiments in an effort to remind Congress the time for mental health parity has come. Their report specifically relays that parity is a critical statement of equality and is cost-effective. Further, any passed legislation must be strongly enforced, carefully crafted to reduce further loopholes, and not interfere with stronger state efforts.

The last point is a major distinction between the House (H.R. 1424) and Senate (S. 558) bills—with H.R. 1424 choosing to not preempt state practices and S. 558 (the Mental Health Parity Act of 2007, which passed out of the Senate Committee on Health, Education, Labor, and Pensions last month) electing to supersede different standards or requirements.

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GAO Report Raises Concerns About Oversight of Children's Dental Services

In connection with a House Oversight and Government Reform Subcommittee on Domestic Policy hearing on May 2, the Government Accountability Office (GAO) released a report that highlights lingering concerns about the sufficiency of data for the Centers for Medicare and Medicaid Services' (CMS) oversight of children's dental services.

Medicaid provides health coverage for approximately 31 million children from low-income families, including most children in foster care. In 1967, Congress guaranteed a comprehensive health benefit known as Early Periodic Screening, Diagnostic, and Treatment (EPSDT) services to individuals under age 21 enrolled in Medicaid, with the aim of identifying and ameliorating at-risk or problematic health conditions before they festered. In 1989, Congress clarified that EPSDT was to include dental services. Tooth decay, after all, as the GAO report explains, is one of the most common infectious diseases among children in the United States and if left untreated, may lead to severe pain, dysfunction, or in rare instances, death.

Both a potentially devastating health issue and a guaranteed benefit under EPSDT, CMS estimates that in FY 2005, only about one-third of Medicaid children received any dental service—which begs the question, why are children not receiving these vital screenings and corresponding treatment? The GAO report found that despite concerted efforts on CMS's part, including requiring each state to report on certain features of its EPSDT dental services, fundamental deficiencies remain. Inconsistencies exist in how states report data, data inaccuracies, and issues with the type of data itself--such as an inability to identify dental services delivered to children in managed care settings. GAO concluded by stressing that more complete and reliable data is necessary to locate the missing link and actually deliver Medicaid EPSDT dental services to the children who need them.

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CWLA Legislative Alerts Available to Subscribers

CWLA's Legislative Alerts provide breaking news, advocacy information, and critically important timely details of legislative battles. In an effort to broaden CWLA's advocacy network on behalf of children, anyone can now subscribe and receive the same information. This effort compliments CWLA's weekly electronic legislative newsletter, the Children's Monitor, which is also available free to any subscriber. We encourage you to register to receive these items directly and to pass on the information to other colleagues, family, and friends.

Subscribe to Legislative Alerts.

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Key Upcoming Dates for Congress

May 1-31: Foster Care Awareness Month
May 13: Mothers Day and "Care About Kinship Week: Sponsor S. 661"
May 26-June 3: Congressional Memorial Day Break


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