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

   
   
Vol. 20, Issue 36: 9/24/2007   
Headlines

CWLA Launches Campaign for White House Conference on Children and Youth

Congress Approaching SCHIP Compromise, House Vote Expected Soon

Mental Health Parity Passes Senate, House Version Clears Committee

CWLA Continues to Gather Feedback on Proposed Rehabilitative Services Regulation

Capitol Hill Briefing Held on Latino Children in Foster Care

CWLA Legislative Alerts Available to Subscribers

Key Upcoming Dates for Congress



CWLA Launches Campaign for White House Conference on Children and Youth

CWLA has launched a campaign for a White House Conference on Children and Youth in 2010. The first such conference was called by President Theodore Roosevelt in 1909 and was followed with a conference held every 10 years. No conference has been held since 1970, however.

Previous conferences made significant contributions to establishing priorities for protecting and supporting children in need. In 1909, the conference committed the nation for the first time to oppose the institutionalization of dependent children. The 1919 conference on Standards of Child Welfare produced the first significant report on child health and welfare standards, and was followed a year later by CWLA's founding. The conference in 1929 created the most comprehensive report on the needs of children ever written and resulted in a national Children's Charter. The last conference in 1970 strived to strengthen the individuality and identity of children through the support of healthy personality development. CWLA has posted a brief history of the conferences on its website.

The conference would focus attention on child welfare and the need for reform. We continue to see far too many children victimized by abuse and neglect. There are approximately 3 million reports of abuse or neglect each year, and 800,000 are substantiated. At the same time, hundreds of thousands of these children wait to be adopted--many have been waiting for years. Astoundingly, fewer than half of children in care receive federal foster care and adoption support, there is an appalling lack of federal support for kinship care, and the child welfare system in dire need of reform.

A White House conference on child welfare is necessary to focus national attention on the children who, after all, are our responsibility. The conference would examine the greatest needs and set the country on a path of reform. The commitment of the President and the power of the White House is necessary to once again make vulnerable children a national priority and point the way to significant reform and improvements.

The campaign invites all organizations and partners advocating on behalf of children to join in this effort for Congress and the next President to authorize and support this White House Conference. This conference offers the chance to help the thousands of children across America.

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Congress Approaching SCHIP Compromise, House Vote Expected Soon

After discussion between the House and Senate, and significant meeting in the middle--especially from House Democrats who were pushing for a larger package--Congress appears to be nearing a deal to reauthorize the State Children's Health Insurance Program (SCHIP) in time to get it to the President's desk before the program's September 30 expiration.

Each state has an SCHIP; combined, they provide much-needed health insurance to more than 6 million low-income children whose families earn too much to qualify for Medicaid, those who are either not offered or cannot afford private coverage, and some lower income adults. At press time, details of the compromise bill were largely still being withheld, but it will most likely be closer to the version the Senate passed by a veto-proof majority of 68-31. Providing approximately $35 billion additional dollars for the successful program, the Senate bill (S. 1893/H.R. 976) would encompass 4 million children who otherwise would go uninsured. CWLA and other national groups have been heavily advocating for Section 814 of the House bill (H.R. 3162) to be included, which would ward off for one year a proposed regulation that would restrict access to the Medicaid rehabilitative services option.

The House is expected to vote on the compromise package September 25, and the Senate shortly thereafter. Congress is coming together for the sake of children and their well-being to try and meet the September 30 deadline, but even if and when the compromise passes, SCHIP still faces a threatened Presidential veto. The New York Times quoted White House spokesperson Tony Fratto cautioning, "The House and the Senate still appear to be far away from legislation that we would find acceptable."

Should a presidential veto occur and SCHIP not officially be reauthorized, a short-term extension is possible, most likely at current funding levels. The Congressional Research Service (CRS) has reported that in that situation, many states would, not surprisingly, run into severe financial hardship. CRS believes 35 states would exhaust their federal SCHIP funds in FY 2008--12 of them facing shortfalls immediately--requiring them to either draw down Medicaid dollars instead or wait for HHS to redistribute FY 2005 allotments.

Also at issue is whether the recent policies announced by the Centers for Medicare and Medicaid Services (CMS) affecting states that already use or plan to use SCHIP to cover children in families who earn over 250% of the federal poverty level (250% of FPL is $51,625 for a family of four) will be addressed as part of SCHIP reauthorization. To cover children in families above 250% FPL through SCHIP, CMS has said states would have to meet certain requirements, including proving that the beneficiaries--in this case, children--have been uninsured for at least an entire year. Such states would also have to show they have enrolled at least 95% of their children below 200% FPL who are eligible for either SCHIP or Medicaid. These policies seem next to impossible to meet, and individuals at the state and federal levels have expressed opposition. If not taken care of during reauthorization, Senators Ted Kennedy (D-MA), Gordon Smith (R-OR), Jay Rockefeller (D-WV), Olympia Snowe (R-ME), Robert Menendez (D-NJ), and John Kerry (D-MA) are backing stand-alone legislation (S. 2049) that would block them.

With votes expected soon, CWLA will be providing updates and issuing action alerts in the coming days. If the President vetoes the legislation as has been indicated, the votes to override will likely be close.

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Mental Health Parity Passes Senate, House Version Clears Committee

On September 18, the Senate passed by unanimous consent its mental health parity legislation, S. 558, which would erase discriminatory limitations by requiring group health plans with 50 or more enrollees who choose to offer mental health benefits to provide them on the same terms as other medical conditions. As it had announced shortly before the August recess, the Senate dropped its special preemption rule, bringing it much closer to the House parity legislation (H.R. 1424), making it a floor by preempting only existing state mental health parity laws that are lower than the federal law, while permitting state mental health parity laws that are stronger and more protective of consumer rights to stand.

Differences do still exist, however. The House bill, for example, has a broader definition of what insurers must cover, whereas the Senate bill would leave it up to employers and insurers to negotiate covered conditions. Championed in a bipartisan fashion by Representatives Patrick Kennedy (D-RI) and Jim Ramstad (R-MN), the House bill has an impressive 270 cosponsors and managed to easily pass the Ways and Means Health Subcommittee on September 19 by a vote of 10-3. The entire House hopes to vote in the near future, making passage of mental health parity legislation a realistic measure for this Congress.

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CWLA Continues to Gather Feedback on Proposed Rehabilitative Services Regulation

To assist members and concerned stakeholders in analyzing the impact of the recently published proposed CMS regulation on Medicaid rehabilitative services, CWLA has posted its working summary and analysis of the proposed regulation on its website. The public has until October 12, 200,7 to submit comments to CMS. CWLA will be submitting its own comments and urges other individuals and groups to do the same. CWLA's working summary and analysis should provide a thorough starting point for discussion and analysis, but please send further feedback on how the proposed regulation would affect children and families, and the agencies and providers who serve them, to Laura Weidner, CWLA Government Affairs Associate for Health, at lweidner@cwla.org.

Many states implement rehabilitative services for various populations, including children in foster care. Rehabilitative services are defined as "any medical or remedial services (provided in a facility, a home, or other setting) recommended by a physician or other licensed practitioner of the healing arts, within the scope of their practice under State law, for maximum reduction of physical or mental disability and restoration of an individual to the best possible functional level." These services are critical to improving the well-bring of children in foster care, as they offer a realistic opportunity to--in the least restrictive setting possible--reduce the physical or mental disabilities many children in foster care have, in a person-centered, evidence-based manner.

The proposed rule (CMS 2261-P/72 FR 45201) is available in its entirety online. Among other provisions CWLA is concerned about, the regulation would establish a fairly strict qualified provider standard and written rehabilitation plan requirement. It would also exclude payment from Medicaid for services that are deemed intrinsic to other programs, including child welfare and foster care. This "intrinsic to" test appears to want to ensure that Medicaid does not pay for services CMS deems are the responsibility of other programs, but no specific guidance is provided as to what intrinsic to really means. Therapeutic foster care services would surely be affected by the proposed rule, as it excludes rehabilitative services from the definition of therapeutic foster care services, except for medically necessary rehabilitation services that are clearly distinct from packaged therapeutic foster care services. By denying federal financial participation, this appears to effectively revoke the option to bundle rates for therapeutic foster care.

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Capitol Hill Briefing Held on Latino Children in Foster Care

Approximately 52,000 Latino children have entered out-of home placements. More than one-fourth of Latino children in the foster care system live with grandparents and other relatives. Many of these relatives could create permanent homes so children could leave foster care, if there were federal government support for relative legal guardianships of foster children.

On September 19, Generations United and Kids Are Waiting hosted a briefing on U.S. Foster Care Reform entitled, "Una Familia para Cada Niņo: Supporting Permanent Families for Latino Children in Foster Care." Panelists included Representative Dennis Cardoza (D-CA); Elba Montalvo, Executive Director, Committee for Hispanic Children and Families, New York, NY; Donna Butts, Executive Director, Generations United; Ernesto Loperena, New York Council on Adoptable Children, New York, NY; Rose Canales, caregiver, Union City, CA; and Joscelynn Carbonell Youth, Santa Maria, CA.

Panelists depicted their experiences living in the child welfare system, the importance of family permanence, the need for greater supports for relative caregivers and kinship care, and next steps necessary to make permanency and stability a reality for Latino children and families who come in contact with the child welfare system. CWLA commends Generations United, Kids Are Waiting, and Representative Cardoza's leadership on this issue and encourages Congress to pass kinship legislation in the 110th Congress.

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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.

Subscribe to Children's Monitor.

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Key Upcoming Dates for Congress

  • September 24-26: CWLA Mid-Atlantic Region Conference
  • September 30: SCHIP reauthorization expires
  • October 1: 2008 federal fiscal year begins
  • October 26: House target adjournment date
  • November 16: Senate target adjournment date


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