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

   
   
Vol. 21, Issue 16: 4/28/2008   
Headlines

House Passes Medicaid Rules Bill with Veto-Proof Majority

Rockfeller, Snowe Urge Administration to Rescind SCHIP August 17 Directive

Miller Introduces Bill to Address Bootcamps

Budget and Supplemental Spending Still Hanging

Child Abuse Registry Requirements Being Studied

GrandRally a Time to Support Grandparents and Other Relatives

CWLA Supports National Children's Mental Health Awareness Day, May 8

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 Passes Medicaid Rules Bill with Veto-Proof Majority

On April 23, with a veto-proof vote of 349-62, the House passed the Protecting the Medicaid Safety Net Act of 2008 (H.R. 5613), which would place a one-year moratorium on seven Medicaid regulations issued by the Bush Administration. The Centers for Medicare and Medicaid Services (CMS) has said the rules are an attempt to clarify existing services and to fight fraud and abuse in the Medicaid program, but many, including CWLA, have concerns that the rules, as written, overreach and will significantly decrease access to health care and other needed services for vulnerable populations, including children and youth involved in the child welfare and foster care systems. 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.

Attention now turns to building support for the moratorium in the Senate. Due to timing constraints--with the case management/TCM rule already in effect and other rules whose moratoria are about to expire-- efforts also are under way to include the moratoria in other legislation moving through Congress. Although the Bush Administration issued a formal veto threat against H.R. 5613 on April 22, members are pressing ahead. Senate Finance Chair Max Baucus (D-MT) said, "I intend to work with my colleagues in the Senate on strategies to stop harmful Medicaid regulations."

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Rockfeller, Snowe Urge Administration to Rescind SCHIP August 17 Directive

Senators Jay Rockefeller (D-WV) and Olympia J. Snowe (R-ME), in reaction to two independent legal analyses, have urged the Bush Administration to rescind its August 17, 2007, policy directive that restricts states' ability to cover children in families above 250% of the federal poverty level (250% of FPL is $51,625 for a family of four) in their SCHIP programs.

Purporting to clarify procedures used by states to prevent crowd-out of private insurance, the directive requires states to 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. Another controversial aspect of the August 17 directive is that states would have to prove that the beneficiaries--in this case, children--have been uninsured for at least an entire year before they could enroll them in an SCHIP program.

Since its release, the directive has been sharply criticized by members of Congress, states, and advocacy organizations, including CWLA, for being overly onerous and without opportunity for public comment. Two nonpartisan reports, requested by Rockefeller and Snowe and released on April 18, make clear the Bush Administration has overstepped its legal authority. The Government Accountability Office (GOA) concluded in its report that the August 17 letter constitutes a rule under the Congressional Review Act (CRA) and. as such, must be submitted to Congress and the Comptroller General before it can take effect. CRA, enacted in 1996, ensures Congress is adequately informed of rulemaking activities of federal agencies, such as the Centers for Medicare and Medicaid Services (CMS), which oversees the SCHIP and Medicaid programs and released the August 17 letter in question.

The Congressional Research Service in its report similarly found the August 17 letter to be a rule under CRA and said the policy cannot go into effect until it is reported to Congress and the Comptroller General. Rockfeller and Snowe, in a joint press release, called on the Administration to voluntarily rescind the directive. A CMS spokesperson has responded however that "GAO's opinion does not change the department's conclusion that the [August 17] letter is still in effect."

In the original 2007 letter, CMS gave states until August 17 of this year to come into compliance with the requirements. Efforts in Congress (S. 2819) would delay the directive's implementation, and a few states have also filed suit against the federal government, alleging the directive violates the Administrative Procedure Act.

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Miller Introduces Bill to Address Bootcamps

On April 24 Representative George Miller (D-CA) introduced the Stop Child Abuse in Residential Treatment Programs for Teens Act of 2008 (H.R. 5876) to better regulate boot camps and other alternative placement facilities and bring transparency to the policies and practices of such programs.

The legislation is a response to numerous studies documenting the ineffectiveness of these programs and, in several instances, tragic deaths as a result of child abuse and neglect as reported by the Government Accountability Office in October 2007. GAO has issued a new report that was the basis of this hearing. The report examined selected cases of abuse, death, and deceptive marketing.

CWLA submitted a letter supporting the direction of the proposal to provide much-needed management over programs and facilities that have for too long operated without adequate state or federal regulation or licensing by. The legislation would prevent corporal punishment, physical abuse, and mental abuse. Programs would be prohibited from using disciplinary techniques that involve the neglect of essential food, clothing, shelter, or medical care. Program could use physical restraint only when necessary for the safety of the child or others, and they would be required to provide children with reasonable access to a telephone and to train staff in what constitutes child abuse and neglect and how to report it.

H.R.5876 would require programs to disclose to parents the qualifications and responsibilities of all current staff members and to notify parents of substantiated reports of child abuse or violations of health and safety laws.

The bill includes an increase in authorized funding for the Child Abuse Prevention and Treatment Act from $120 million to $200 million for states to institute these initiatives, and a separate authorization of $50 million for the U.S. Department of Health and Human Services (HHS) to establish inspections and regulations.

The legislation is expected to be considered for approval by the full committee in the next few weeks.

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Budget and Supplemental Spending Still Hanging

Two tracks of discussions regarding the federal budget continued last week. The first and most immediate was a new supplemental spending bill that would provide an addition $108 billion in funding for the war to cover costs this fiscal year. This would be in addition to the approximate $80 billion that has already been approved and spent.

The President is all but certain to get the additional $108 billion in funds, but the debate within the Congressional leadership is whether to include additional domestic spending, including an antirecession package of relief measures. The Administration is against any additional spending not related to the war. Some antiwar Democrats in the House are also opposed to attaching additional domestic spending, wanting to keep the focus on the war itself.

At the same time, there has been no agreement on a budget resolution for FY 2009. Failure to act would make it more difficult to negotiate differences between the Senate and House appropriations bills. It would also mean no reconciliation bill could be used as a vehicle to pass changes to mandatory or entitlement programs, which would include child welfare reform.

The inability to get a budget resolution passed adds to the likelihood that only a few appropriations bills will be passed this year and that most spending, including money for HHS, would be left for the new President to decide after November and perhaps as late as next January.

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Child Abuse Registry Requirements Being Studied

Section 633 of the 2006 Adam Walsh Child Protection and Safety Act (P.L. 109-248) includes a mandate to create a national child abuse registry based on current state child abuse registries. Creation of such a registry requires a study HHS, and the Office of the Assistant Secretary for Planning and Evaluation (ASPE) recently announced it is conducting that feasibility study.

The legislation dealt with child predators for the most part, but it developed into a collection of various items, with some touching on child abuse and child welfare. The creation of a national child abuse registry creates several challenges state agencies and advocates have raised. State child abuse registries do not necessarily include individuals who have been convicted of any crime. Concerns also exist about how states differ in their definitions of child abuse and neglect, their standards for substantiation of abuse and neglect, differing requirements for an appeals process to remove an individual's name from such a list, how a national registry would be used, and who would have the authority to use it.

The law calls on HHS to "collect, in a central electronic registry, information on persons reported to a State, Indian tribe, or political subdivision of a State as perpetrators of a substantiated case of child abuse or neglect." In addition, HHS is to conduct a study on the feasibility of establishing data collection standards for a national child abuse and neglect registry before creating a registry. The study "shall include recommendations and findings concerning-- (A) costs and benefits of such data collection standards; (B) data collection standards currently employed by each State, Indian tribe, or political subdivision of a State; (C) data collection standards that should be considered to establish a model of promising practices; and (D) a due process procedure for a national registry."

Contact Laura Radel at HHS at 202-690-5938 or Laura.Radel@hhs.gov to offer information on the various issues raised by the law. The full text of Adam Walsh Act, including section 633 regarding the registry and feasibility study, is online.

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GrandRally a Time to Support Grandparents and Other Relatives

On May 7, hundreds of grandparents and other relatives raising children will gather at the U.S. Capitol for a GrandRally to highlight their important role in raising children and the help they need from family, friends, their communities, states, national organizations and agencies, and elected officials.

The GrandRally is an historic gathering of grandparents and other relative caregivers from across the country that brings attention to the needs of children and kinship care families. It's an important opportunity to educate Members of Congress and their staffs about the supports and services kinship families need. The GrandRally also offers caregivers, advocates, and Members of Congress the chance to recognize and celebrate the essential role that grandparents and other relative caregivers play in keeping children safe and in stable families.

More than 850 grandparents and other relatives raising children, from 28 states and the District of Columbia, attended the first national GrandRally in October 2003. The second GrandRally grew to include 1,000 grandparents, relative caregivers, and advocates from 41 states and DC. This year's GrandRally is sponsored by AARP, the Children's Defense Fund (CDF), CWLA, Generations United (GU), GrandFamilies of America, and the National Committee of Grandparents for Children's Rights (NCGCR).

The rally will take place on Wednesday, May 7, 2008 at 1:00 p.m. on the West Grassy Front of the U.S. Capitol in Washington, DC. View more information.

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CWLA Supports National Children's Mental Health Awareness Day, May 8

CWLA is joining with the Substance Abuse and Mental Health Services Administration (SAMHSA) to support the third annual National Children's Mental Health Awareness Day on May 8. Awareness Day is an opportunity for SAMHSA, SAMHSA-funded communities, and partner organizations such as CWLA to promote positive youth development, resilience, recovery, and the transformation of mental health services delivery for children and youth with serious mental health needs, and their families.

The theme for this year's Awareness Day is Thriving in the Community, highlighting that high school youth who receive the services they need are more likely to have positive outcomes such as better grades and higher rates of education, and less likely to have negative outcomes such as involvement with the juvenile and criminal justice systems.

Moderate to severe mental health and behavioral problems affect 50%-80% of children in out-of-home care. Despite the disproportionate need, some estimate only about 25% of children in foster care receive mental health services at any given time. Consequently, CWLA and our members have long been committed to better addressing the mental health care needs of children and youth in the child welfare system and to the system of care philosophy in child mental health services.

CWLA has several resources available, including the September/October 2007 special issue of Child Welfare Journal focusing on effectively addressing mental health in child welfare practice and the CWLA Standards of Excellence for Health Care Services for Children in Out-of-Home Care. CWLA is also actively involved in several pressing children's mental health policy issues, including preserving access to vital Medicaid services through the Rehabilitative Services option and achieving mental health parity.

For more information about what your community and organization can do to support National Children's Mental Health Awareness Day on May 8, visit SAMHSA's website.

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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 30, The Health Care Needs of Children in Foster Care

Join us for a lively discussion with experts on legislative actions regarding the the health care needs of children living in foster care. Note: The previously schedule show regarding children with parents in prison has been rescheduled for June.

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

  • May 1: Start of National Foster Care Month
  • May 7: Third National Grand Rally on Capitol Hill
  • May 15: Target date for House to begin passage of 12 appropriations bills
  • June 27: Target date for House to complete work on Appropriations
  • June 29-July 6: July 4th Congressional Break


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