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

   
   
Vol. 20, Issue 47: 12/10/2007   
Headlines

Signing Session by House Speaker Sends Head Start to the President

Final Interim Rule Posted on Medicaid TCM

Capitol Hill Briefing Focuses on Overrepresentation of Children of Color in Child Welfare

Senate Committee Holds Hearing on Juvenile Justice

CHIP Extension Likely

Join CWLA's Call for a White House Conference on Children and Youth

CWLA Legislative Alerts Available to Subscribers

Key Upcoming Dates for Congress



Signing Session by House Speaker Sends Head Start to the President

House Speaker Nancy Pelosi (D-CA) gathered key legislative leaders on Head Start, including Senator Edward Kennedy (D-MA) and Representatives George Miller (D-CA), Mike Castle (R-DE), and Dale Kildee (D-MI), in an event last week to formally enroll the Head Start reauthorization, the Improving Head Start for School Readiness Act of 2007. Enrolling is the last formal step before a bill is sent to the White House. The President is expected to sign the legislation.

The enrolling session included a number of Head Start advocacy groups, including CWLA, and five young Head Start students. Everyone was treated to a rendition of "The Itsy Bitsy Spider" sung by Senator Kennedy and other legislators. The bill passed the House and Senate in mid-November. The final vote in the House was 381-36, and the Senate approval was 95-0.

Although the program had expired in 2003, it continued through the annual appropriations process. Since 2003, Congress has considered and rejected previous Administration proposals to convert Head Start into a block grant or to block-grant pilot projects, moving the program to the Department of Education from HHS, and testing Head Start children, referred to as the National Reporting System. The new reauthorization sets a national goal of 50% of Head Start teachers having bachelor's degrees by 2013 and provides some limited expansion of Head Start eligibility to families up to 130% of poverty under certain conditions.

Pelosi called the reauthorization an example of what Congress can do when it works together. She also said the bill was a follow-up to the Children's Summit she called earlier this year.

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Final Interim Rule Posted on Medicaid TCM

The Centers for Medicare and Medicaid Services (CMS) recently published an interim final rule on Medicaid targeted case management (TCM) clarifying the definition of case management services as instituted by Section 6052 of the Deficit Reduction Act (DRA), and thus determines when federal Medicaid dollars are available for such services. The regulation may be downloaded in PDF format.

The TCM option allows states to target a select population (such as children in foster care) to receive in-depth case-management services--even across child-serving systems--thereby helping the child access much-needed medical, social, educational, and other services. At least 38 states employ the TCM option to provide greater coordination of care for children in foster care. Children who have TCM services are more likely to receive have medical, prescription drug, dental, rehabilitative, inpatient, and clinical services.

DRA retained and clarified the following as permissible case management in the context of medical assistance:
  • assessment of an eligible individual to determine service needs for any medical, educational, social, or other social service (including taking client history or gathering information from other sources such as family members);
  • development of a specific care plan;
  • referral and related activities to help an individual obtain needed services; and
  • monitoring and follow-up activities.
DRA specifically excluded from the definition, however, "the direct delivery of an underlying medical, educational, social, or other service to which an eligible individual has been referred, including with respect to the direct delivery of foster care services."

DRA also provided a nonexhaustive list of foster care services that are no longer eligible for Medicaid reimbursement:
  • research-gathering and completion of documentation required by the foster care program,
  • assessing adoption placements and making the placement arrangements,
  • recruiting or interviewing potential foster care parents,
  • serving legal papers,
  • conducting home investigations, or
  • administering foster care subsidies.
As mentioned, the interim final regulation interprets DRA's impact on TCM. CMS anticipates the changes will reduce federal Medicaid spending on TCM by $1.28 billion over five years. In doing so, costs are expected to overwhelmingly shift to the federal IV-E foster care program, increasing federal spending on IV-E by $369 million over five years.

CWLA is analyzing the substantive provisions of the regulation and urges all stakeholders to do the same and submit corresponding comments to CMS before the end of the 60-day comment period.

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Capitol Hill Briefing Focuses on Overrepresentation of Children of Color in Child Welfare

On December 5, Representative Jim McDermott (D-WA) and staff from the House Ways and Means Committee participated in a briefing on the challenge of reducing the high number of African American children in the foster care and child welfare system. The briefing was conducted by the Casey-CSSP Alliance for Racial Equity in Child Welfare.

The briefing began with remarks by McDermott, Chair of the Ways and Means Subcommittee on Income Security and Family Support, which has jurisdiction over child welfare programs such as foster care, adoption assistance, and some of the abuse and neglect prevention programs. McDermott indicated he intended to hold a hearing on the issue of disproportionality and that he is working with other members of Congress on legislation focused on kinship care and youth aging out of the child welfare system.

The briefing highlighted the recent report by the Government Accountability Office on the high percentage of children of color in the child welfare system. According to the report, African Ameican children represent approximately 36% of the children in the child welfare system, but only 15% of the population. Moderator Khatib Waheed, Center for the Study of Social Policy, said that beyond the national level, overrepresentation also exists in certain states and counties for Hispanic and Native American populations.

The Alliance called for improvements in financing child welfare with funding for kinship placements and prevention services, and greater involvement of families in the decision-making process. The Alliance includes the Casey family of foundations, the Center for the Study of Social Policy, The Race Matters Consortium, and Black Administrators in Child Welfare. For more information, go online.

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Senate Committee Holds Hearing on Juvenile Justice

On December 5, the Senate Judiciary Committee held a hearing on the Juvenile Justice and Delinquency Prevention Act (JJDPA). It was the first such hearing in eight years and signaled the Senate's growing interest in reauthorizing the legislation.

Witnesses focused comments on strengthening the core protections for youth who come in contact with law enforcement, and in supporting prevention and rehabilitation, the act's basic tenants. The core protections that drew the most discussion were removing youth from adult jails and prisons, not allowing status offenders to be placed in detention, and the provision on addressing the racial and ethnic disparities in the juvenile justice system.

Comments from Senators in attendance reflected strong support for these provisions. Similarly, they were unanimous in their support of the basic foundations of the act, preventing delinquency and rehabilitating youthful offenders. They spoke of their support for improving and strengthening the act rather than making wholesale changes.

Robert Flores, Administrator of the U.S. Office on Juvenile Justice and Delinquency Prevention, was one of the witnesses and was challenged on the drastic cuts in funding for juvenile justice in the past five years. He responded that federal funds have become a magnet for state and local resources devoted to these efforts.

CWLA is one of the leading organizations involved in working with Congress to reauthorize JJDPA. We participate in the Act4JJ Coalition in this regard. The coalition has developed a website that includes numerous resources and documents on juvenile justice, including a statement of principles for improving and strengthening the JJDPA. Go to www.Act4JJ.org.

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CHIP Extension Likely

After Congress managed to pass two strong, forward-moving bills to expand the Children's Health Insurance Program (CHIP), internal gridlock and opposition from the Administration apparently have crushed the opportunity for a five-year reauthorization. CHIP programs exist in every state and provide much-needed health insurance to more than 6 million children whose families earn too much to qualify for Medicaid and those who are either not offered or cannot afford private coverage.

Having begun in a bipartisan fashion 10 years ago, and known as an overall success, CHIP's reauthorization has been a priority for many members of Congress this year. Both bills that Congress passed would have maintained current enrollment for more than 6 million children and encompassed nearly 4 million additional children in either Medicaid or CHIP, most of whom are already eligible for these programs.

President Bush vetoed Congress's first bill (H.R. 976), citing among his various points of disagreement the bill's price tag and its method of payment. Congress sent its second reauthorization bill (H.R. 3963), which sought to address opponents' concerns, to the President on November 30, and he is expected to veto that bill as well.

A bicameral, bipartisan group of lawmakers have been meeting and negotiating for more than a month to try and further a long-term reauthorization, and although talks seemed to be flowing at first, they largely broke down before the Thanksgiving recess. CHIP officially expired September 30 and has since been operating through continuing resolutions, the latest of which expires December 14. Congress is expected to pass a simple extension of the program, possibly through the end of the fiscal year. This is due to the expected veto from the White House, the apparent impasse among members of Congress, and the fast-approaching December 14 expiration--compounded by Congress's extremely full agenda.

The Congressional Research Service has estimated that if merely flat-funded, however, 21 states would exhaust all federal CHIP funds by the end of FY 2008. Children's advocates, therefore, including CWLA, are urging that if a five-year reauthorization is impossible, and a shorter-term extension is necessary, Congress must, at minimum, provide additional, sufficient funding to maintain current enrollment and program operations. House Republican Whip Roy Blunt (R-MO) has indicated that Republicans would support such an inclusion of extra money to avoid shortfalls at the state level.

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Join CWLA's Call for a White House Conference on Children and Youth

Holding a White House Conference on Children will bring together a cross-section of policymakers, advocates, professionals (including the courts), and families and children directly affected by the child welfare system to create recommendations for policy and change. Much positive change has come from previous White House conferences for children, the last one being held in 1970. CWLA is calling on Congress and the next President to reestablish this important policymaking tradition, and the time to act is NOW.

Your support and involvement with this effort is crucial to its success. As experts in the field, we look to you for your leadership in asking Congress and others to support this important campaign for children.

Sign On in Support

CWLA is calling on members and supporters to sign on in support of a White House Conference on Children in 2010.

Pass a Board Resolution

If your organization requires you to pass a board resolution to officially support such an effort, CWLA has created a sample resolution to assist you in this effort.

Let Congress Know of Your Support

The League encourages you to send your resolutions and letters of support to your Congressional delegation. Without their support, a White House conference is not possible.

In keeping with CWLA's tradition of nonpartisanship, the letter has been sent to all presidential candidates in the two major parties. View the website, read the letter, and sign on to support the campaign.

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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

December 14: Target adjournment date
Continuing resolution to fund the government expires
January 15: Start of Second Session of 110th Congress
January 22: President's State of the Union Address
February 4: President's proposed FY 2009 budget submitted to Congress
February 25-27: CWLA National Conference


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