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

   
   
Vol. 21, Issue 14: 4/14/2008   
Headlines

House Bill to Stop Medicaid Regulations Moves Forward

Senate Hearing on SCHIP Directive; Medicaid Chief Leaving

Juvenile Justice Briefings on the Hill

ACF, CDC Release Infant Maltreatment Study

2006 Child Maltreatment Report Released

New CWLA Radio Blog, "Speaking for America's Children"

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

CWLA Legislative Alerts Available to Subscribers

Key Upcoming Dates for Congress



House Bill to Stop Medicaid Regulations Moves Forward

On April 9, the House Energy and Commerce Subcommittee on Health approved the Protecting the Medicaid Safety Net Act of 2008 (H.R. 5613) by voice vote. The bill places a one-year moratorium on seven Medicaid regulations issued by the Bush Administration, including rules that threaten the future of rehabilitative services and case management/targeted case management services (CM/TCM) for children and youth involved in the child welfare and foster care systems, and several other vulnerable populations. The intent behind the moratorium is to give Congress time to determine whether the rules are in line with Congressional intent and are the best policy decisions for Medicaid beneficiaries.

The voice vote occurred after a substitute amendment, containing compromises agreed to by both sides of the aisle, was accepted. The amendment, offered by Energy and Commerce Chair John D. Dingell (D-MI), clarifies the scope of the moratorium, requires the U.S. Department of Health and Human Services (HHS) to justifiy the rules, requires an independent body to conduct impact analyses of the rules, and authorizes additional funding to HHS in the amount of $25 million per year to fight fraud and abuse in the Medicaid program. Many members throughout the markup thanked and applauded each other for putting "needs before partisan politics." Energy and Commerce Ranking Member Joe Barton (R-TX) supported the substitute bill and said he would urge the Administration to support it as well.

The full Energy and Commerce Committee is expected to consider the bill this week, hopefully followed soon after by a full House vote. The bill has an impressive 130 cosponsors and support from more than 1,000 organizations, including CWLA.

A similar bill (S. 2819), which CWLA also supports, is being championed in the Senate by Senators Jay Rockefeller (D-WV), Olympia Snowe (R-ME), and Edward Kennedy (D-MA). In addition to delaying the seven Medicaid regulations contained in the House bill, S. 2819 would also postpone the August 17, 2007, policy directive (see the next article) issued by the Centers for Medicare and Medicaid Services (CMS), restricting states' abilities to cover children in families above 250% federal poverty level through their SCHIP programs, and a rule granting significant discretion to the HHS in reviewing decisions of the Departmental Appeals Board.

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Senate Hearing on SCHIP Directive; Medicaid Chief Leaving

The Senate Finance Subcommittee on Health heard testimony on April 9 about the impact of a policy directive issued by CMS last August that greatly restricts states' abilities to cover children in families above 250% of the federal poverty level (FPL) through their State Children's Health Insurance Programs (SCHIP; 250% of FPL is $51,625 for a family of four).

Recognizing that states are very differently situated--in terms of costs of living, for example--the federal government has long afforded states flexibility to uniquely tailor certain aspects of their SCHIP and Medicaid programs, including the ability to set income eligibility limits. In a sharp departure, however, the August 17, 2007, directive enumerated new, stringent requirements that states that already cover or wish to cover children in families above 250% FPL must come into compliance with by August of this year.

Members and panelists during the hearing displayed differences of opinion as to the Administration's intent behind the policy. of the Health Subcommittee Chair Jay Rockefeller (D-WV) said in his opening statement that "its aim is simple: to make it virtually impossible to provide greater access to health insurance for children." Ranking Senate Finance Member Charles E. Grassley (R-IA) indicated that the policy's intent--which he agrees with--is to ensure that the lowest-income children are covered first and crowd-out is reduced.

Members and panelists also grappled over whether the policy directive would achieve its stated goals. Many of the directive's requirements have come under fire, with states and advocates urging that their bar is too high. For instance, under the directive, states must prove they have enrolled at least 95% of their children below 200% FPL who are eligible for either SCHIP or Medicaid before moving up the income eligibility ladder.

Dennis Smith, Director CMS's Center for Medicaid and State Operations, called this provision "aggressive, but achievable." Smith testified that after discussions with the states, CMS believes that at least 9 of the 17 states currently covering children in families above 250% FPL could continue to do so. Other panelists, such as Congressional Budget Office Director Peter Orszag, questioned the Administration's estimates and expressed concern that the 95% threshold would bind states unnecessarily and restrict efforts to increase access.

The process by which the directive was issued-- in the form of a letter to state health officials without public comment period--was touched upon, as well. Rockefeller challenged that CMS's actions violated the Administrative Procedure Act, an allegation that certain states are also claiming in various lawsuits against HHS on the directive. Smith, however, maintained that the agency's authority was proper.

Smith also confirmed during the hearing that he was leaving CMS April 11. In his director's role, Smith oversaw state development and implementation of federal policies governing certain programs, including Medicaid and SCHIP. He was appointed to the position in 2001 and led the evaluation of state programs and the issuance of policy directives, such as the August 17 letter.

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Juvenile Justice Briefings on the Hill

On April 7, CWLA participated in two briefings on Capitol Hill to urge Congress to increase funding for juvenile justice programs. Presenters included young people who are part of delinquency prevention efforts in their communities.

Jazmyne Ford, a member of StrongGirls, in Birmingham, Alabama, spoke about her troubled childhood and how her life changed after getting involved in StrongGirls, a counseling and mentoring program. Angelo Estevez, Newton, New Jersey, described the Peers Making Peace Program he participates in at his school, which reduces violence and bullying by mediating conflicts.

Federal funding for juvenile justice was increased slightly in FY 2008, but because support has been cut more than 35% since 2002, CWLA and other national organizations are urging Congress to continue with increases to at least get back to 2002 funding levels.

At the briefing, three programs were highlighted for special attention. The Title II Formula Grant program has been cut by 16%. This supports system improvements for the states. The Juvenile Accountability Block Grant (JABG) has been cut by almost 80% in the past six years. JABG is an essential funding source for early intervention and accountability programs at the local level. The Title V Delinquency Prevention Grant program has been cut 35% over this time. Title V is the only federal funding designated specifically for primary prevention, which targets youth who have not had contact with law enforcement but who have high risk factors.

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ACF, CDC Release Infant Maltreatment Study

Using data from the National Child Abuse and Neglect Data System, the Centers for Disease Control and Prevention (CDC) published a report on Infant Maltreatment in the April 4 edition of Morbidity and Mortality Weekly Review. The new study looked at children under age 1.

A total of 91,278 infants were victims of nonfatal maltreatment in FY 2006. Of this number, 38.8% were younger than 1 month, and of that number, 84.3% were younger than 1 week. Of the victims under 1 week of age, 86.9% were reported to children's protective service agencies by health care and social service professionals. Most of these week-old infants (68.4%) were victims of neglect. Specific causes and circumstances for the neglect are not available in the report. Previously, statistics on child maltreatment included the category of children younger 3 years but did not provide any additional age-related detail.

The Administration for Children and Families (ACF) and CDC discussed ways to prevent child maltreatment. They emphasized the need for very early intervention to keep children safe in their earliest days of life. Home visiting programs were mentioned as a prevention method already being used and which will be expanded by ACF this year. Substance abuse issues are presumed to be a factor in many cases of maltreatment, and CDC supports programs to address this.

During the press conference releasing the report, Ileana Arias, Director, CDC National Center for Injury Prevention and Control said, "These findings beg for additional research to clarify the causes and maximize strategies to prevent child maltreatment." The report refers to existing research demonstrating the effectiveness of home visitation programs and in-hospital education aimed at reducing shaken baby syndrome.

The report can be downloaded at www.cdc.gov/mmwr/PDF/wk/mm5713.pdf.

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2006 Child Maltreatment Report Released

ACF has released child maltreatment data for 2006 showing a similar pattern as previous years. The report indicates 905,000 victims in 2006, compared with just fewer than 900,000 in 2005. In 2006, 1,530 children died of abuse and neglect, compared with 1,460 in 2005. Just under 65% of child victims experienced neglect, 16% were physically abused, nearly 9% were sexually abused, and more than 6% were emotionally or psychologically abused. These numbers are similar to previous years. Another consistent figure is that approximately 40% of children who have been substantiated as abused or neglected did not receive follow up services; this has been a consistent statistic over the last several years.

Under the Child Abuse Prevention and Treatment Act, states are required to designate certain professions as mandatory reporters, meaning these professions must report abuse when they become aware of it. According to this report, the single biggest categories of reporters of abuse were teachers, followed by legal professionals, including police at 15%, and social workers at 10%. Medical personal were responsible for 8% of abuse reports, with mental health personnel reporting an additional 4%. The report is the result of the National Child Abuse and Neglect Data System. This is the 17th annual report. Read the complete report.

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New CWLA Radio Blog, "Speaking for America's Children"

On the Line with CWLA is a thought-provoking, interactive, live Internet radio program focusing on subjects, stories, and strategies of special interest to child welfare policymakers, providers, and practitioners. The program, devoted solely to discussions about the welfare of America's vulnerable children, features a forum where numerous points of view and voices of experience within the child welfare universe can be heard.

To listen to On the Line with CWLA, go to www.blogtalkradio.com/CWLA-Radio. The call-in number is 347/326-9411.

The live program, hosted by broadcasting veteran Tony Regusters, is a production of CWLA that will provide a platform for CWLA member organizations, their staffs, its partners, and concerned citizens in the national community to share ideas and thoughts about critical issues that affect child welfare agencies, vulnerable children and teens, and their families.

The weekly subject-oriented, solutions-driven program will broadcast Wednesdays, 2:00-2:30 pm ET and feature indepth, timely discussions with leading child welfare experts, agents, and advocates; leadership and representatives from CWLA's member agencies; and local and national political figures working to improve child welfare and give a voice to child welfare professionals, providers, and practitioners nationwide.

Upcoming Shows

April 23, Family Matters: Kinship Caregivers Nationwide Convene at the Capitol

On Wednesday, May 7, grandparents and other relatives raising the children of family members will converge at noon on the West Grassy Front of the U.S. Capitol in Washington, DC, for the third annual Grand Rally. This historic gathering of kinship caregivers from across the country is a call to action for increased support services and financial resources for kinship caregiving--a parental paradigm that allows children to live with and be cared for by their kin in a safe and stable family environment that maintains their well-being.

In support of the coming Grand Rally at the Capitol, this week's program features a timely discussion to raise awareness about the tireless efforts and imperative needs of kinship caregivers--family members who care for millions of children when their parents are unable to do so.

April 30, Broken Bonds: Children with Parents in Prison
More than 2 million minor children have a parent in the criminal justice system--children who are traumatized by separation from their parents, confused by their parents' actions, and stigmatized by the shame of their parents' situation. During the past decade, the number of minors with mothers in prison has increased dramatically. Since women are usually the primary and sometimes sole caregiver for their children before incarceration, the escalating numbers of children with mothers in prison are a mounting challenge for the child welfare system.

This week's program features a moving discussion about the needs and experiences of children with incarcerated parents.

The call-in number is 347/326-9411. Visit www.blogtalkradio.com/CWLA-Radio.

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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

    April: Child Abuse Prevention Month
    April 15: Target date to pass Congressional budget resolution
    April 25: Children's Memorial Flag Day
    May 15: Target date for House to begin passage of 12 appropriations bills
    June 27: Target date for House to complete work on Appropriations


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