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

   
   
Vol. 21, Issue 18: 5/12/2008   
Headlines

Medicaid Rules Moratorium Included in War Supplemental, but Consideration Delayed

Supplemental Debate Continues This Week

Subcommittee Examines Prescribed Psychotropic Medications for Foster Children

GrandRally Draws Grandparents, Relatives, Kids to Capitol Hill

Casey Introduces Major Child Care Legislation

CWLA Radio, 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



Medicaid Rules Moratorium Included in War Supplemental, but Consideration Delayed

Both the planned House supplemental war appropriations bill and the Senate Appropriations Committee's war supplemental mark include a one-year moratorium on seven Medicaid regulations issued by the Bush Administration, including delays on the rehabilitative services and case management/targeted case management (CM/TCM) rules. H.R. 5613, a bipartisan bill championed by Energy and Commerce Committee Chair John Dingell (D-MI) and Representative Tim Murphy (R-PA), also delays the seven Medicaid rules. H.R. 5613 passed the House April 23 with a veto-proof majority but has been held up in the Senate. To break the filibuster on H.R. 5613, Senate Majority Leader Harry Reid (D-NV) would have to file a cloture petition and use valuable but scarce floor time. The supplemental war appropriations bill, then, is now a likely vehicle to carry the moratorium.

When the full House tried to consider its war supplemental bill on May 8, House "Blue Dog" Democrats, who are concerned that portions of the bill do not comply with pay-as-you-go requirements, used slowing tactics to voice their objections to the bill. House Speaker Nancy Pelosi (D-CA) thereafter delayed taking up the legislation, which in turn, caused Senate Appropriations Chair Robert Byrd (D-WV) to delay his committee's scheduled markup. Democrats still hope to send President Bush the measure by Congress's Memorial Day recess. The President has threatened to veto the bill if it exceeds his funding request of $108.1 billion in war funds for the remainder of FY 2008.

Legislation delaying the Medicaid rules very much needs to be signed into law in a speedy manner, as some of the rules, including the CM/TCM services rule, are already in effect or simply not under moratorium. Other rules' moratoria are about to expire, such as the moratorium on the rehabilitative services rule, which expires June 30.

For an informative conversation about the Medicaid rules' impact on states, as well as the child welfare and foster care systems and the vulnerable populations they serve, listen to a recording of CWLA's May 1 Internet radio program, "Policy Actions on Health Care Coverage for Foster Children."

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Supplemental Debate Continues This Week

Much of this week's congressional action is expected to involve passage of a supplemental appropriations bill. For now all talk on a budget resolution for FY 2009 has been set aside. As noted in the previous article, the debate on a war supplemental bill was delayed last week when budget conservative Blue Dog Democrats objected to provisions included in the bill by House leaders. The supplemental would provide $183 billion in additional funding, most of it for the war.

Under the House leadership plan, the supplemental would be voted on in three parts or amendments. The first would be $162 billion for the war for the rest of this year and the early part of the next Administration. The second would offer a vote to set restrictions on the President's Iraq policy. The third would include an extension of unemployment insurance and new benefits for veterans and a freeze on seven Medicaid regulations the Administration is trying to impose.

The Blue Dogs' objection is that the veterans and unemployment spending is not offset or paid for; there does not seem to be an objection to the Medicaid provisions. The overall package does not exceed the President's request, but it does shift some spending. The war funding would not be offset and instead would be considered emergency spending, not requiring it to be paid for and instead adding to the deficit.

The House leadership had hoped to pass the supplemental last week. The bill bypassed the Appropriations Committee and came directly from the House Rules Committee a tactic House Republicans criticized. The Senate was seeking a similar strategy to bypass the Appropriations Committee, but Appropriations Chair Robert Byrd (D-WV) has indicated he will vote on his own bill anyway. That Senate bill includes some of the same provisions as the House bill, including the freeze on the Medicaid regulations, but spends approximately $9 billion more than the House bill.

Senate Majority Leader Harry Reid (D-NV) intends to take up the House bill once it is sent to the Senate. For the Senate to include the Byrd version of appropriations would require an amendment and 60 Senate votes. If that fails, the House bill will stand. An effort to strike the Medicaid freeze provisions is likely to also require 60 votes.

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Subcommittee Examines Prescribed Psychotropic Medications for Foster Children

On Thursday, National Children's Mental Health Awareness Day, the House Ways and Means Subcommittee on Income Security and Family Support, chaired by Jim McDermott (D-WA), held a hearing on Prescription Psychotropic Drug Use Among Children in Foster Care.

In his opening remarks, McDermott noted that children in foster care are 3-4 times more likely to be prescribed psychotropic medication than other children receiving Medicaid services. McDermott said that as a child psychiatrist who understands that children coming into foster care have suffered various degrees of trauma, he did not doubt that "some of them may benefit from medication." Still, he continued, "I also worry that foster children may sometimes be prescribed psychotropic drugs because such treatment is easy and quick--as opposed to effective and appropriate."

Panelists repeatedly emphasized those initial sentiments--that children in foster care, many times coming from families with mental illness and substance abuse, may have a genetic predisposition to mental illness and that subsequent abuse and neglect, placement into foster care, and multiple placements thereafter, only compound their likelihood to develop significant mental troubles.

Christopher Bellonci, Medical Director of The Walker School in Needham, Massachusetts, who also sits on CWLA's Mental Health Advisory Board, testified that the "critical question...is whether medication is being prescribed appropriately and ensuring that all of the child's mental health needs are adequately being addressed." To that end, Bellonci discussed the need for long-term studies to determine the safety and efficacy of psychoactive medications on this particular age group, rather than relying on data from adult subjects. Bellonci also discussed his noteworthy work drafting medication monitoring guidelines for use by Tennessee child welfare workers.

Other panelists proffered their recommendations for increasing foster children's mental health and better regulating the use of psychotropic drugs. Laurel K. Leslie, for example, testifying on behalf of the American Academy of Pediatrics, urged that all children, including children in foster care, must have a medical home. Leslie also said every child should receive a mental health assessment within 30 days of entering state custody, care must be properly coordinated, and child welfare agencies and health care providers should develop and implement systems to ensure the efficient transfer of physical, developmental, and mental health information among professionals who treat children in foster care.

View tesimony from the hearing online.

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GrandRally Draws Grandparents, Relatives, Kids to Capitol Hill

On Wednesday, hundreds of grandparents and other relatives raising their grandchildren, nieces, and nephews gathered on Capitol Hill for the third GrandRally to highlight their important role in raising relative children. The crowd heard from a series of speakers, then went to visit their members of Congress in support of S. 661 and HR 2188.

These two bipartisan bills would extend Title IV-E foster care and adoption assistance to some of these kin families. The bills would also require states to notify relatives when a child enters the states child welfare system, and provide funding to help states set up kinship navigator networks to assist all kin providers in need of information and support groups. The Senate bill is sponsored by Senator Hillary Clinton (D-NY) and Olympia Snowe (R-ME), and the House bill is sponsored by Representatives Danny Davis (D-IL) and Tim Johnson (R-IL).

Support for the two bills has been increasing. The Senate has 30 cosponsors, with 5 having joined since the beginning of April. The House bill has picked up 19 additional cosponsors since the beginning of April, for a total of 61.

GrandRally speakers included leaders of the six sponsoring organizations including Christine James-Brown, President and CEO of CWLA. The grandparents and children also heard from Representative Jim McDermott (D-WA), Chair of the House Subcommittee on Income Security and Family Support, and bill sponsor Representative Davis.

The GrandRally is an historic gathering of grandparents and other relative caregivers nationwide that brings attention to the needs of children and kinship care families. More than 850 grandparents and other relatives raising children, from 28 states and the District of Columbia, attended the first national GrandRally in 2003. More than 1,000 grandparents, relative caregivers, and advocates from 41 states and the District of Columbia attended the second GrandRally. This year's GrandRally was sponsored by AARP, the Children's Defense Fund, CWLA, Generations United, GrandFamilies of America, and the National Committee of Grandparents for Children's Rights.

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Casey Introduces Major Child Care Legislation

Senator Robert Casey (D-PA) has introduced S. 2980, the Starting Early Right Act, which seeks to enact major reforms with the nation's child care system. Endorsed by more than 20 child care and child advocacy organizations including CWLA, the Center on Law and Social Policy, the National Association of Child Care Resource and Referral Agencies, the National Association for the Education of Young Children, National Council of La Raza, the National Women's Law Center, and Zero to Three, the legislation attempts to increase child care access, improve child care quality, create stability, and focus attention on infants and toddlers.

The bill would increase spending by $10 billion a year and require states to spend at least 15% of their funding on child care quality improvements. Current law requires states to allocate just 4% to quality. In additio, the Casey bill would strengthen current reimbursement requirements, directing states to reimburse child care providers at 75% of the market rate, meaning that a state's reimbursement rate covers at least 75% of the child care provider market. The legislation would also target a higher percentage of funds to increase the availability and the quality of child care for infants and toddlers.

For next year, the Bush Administration has proposed funding equal to this year, with a request at just over $2 billion. This is a continued freeze for child care funding, as the Administration predicts child care services will continue to decline. For seven years in a row, the Administration has offered a freeze in discretionary child care funds. The Administration projections show a loss of 200,000 child care slots by 2009 if its request is approved.

Federal child care funding comprises both discretionary and mandatory child care dollars. The mandatory funding is now $2.9 billion and is provided through Temporary Assistance for Needy Families (TANF). Funding was increased by $200 million with the reauthorization of TANF in 2006, but as a result of that reauthorization, child care mandatory funds will not increase again through FY 2010. The Casey bill would change that funding level and attempt to make up for loses from the past decade.

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CWLA Radio, 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 for May

May is National Foster Care Month. During May, On the Line with CWLA presents a series of programs to raise awareness about the needs of children in foster care and inspire people to actions that will make a difference.

Wednesday, May 14
In Their Words: The Perspectives of Adolescents Aging Out of Foster Care


What happens to foster youth when they grow up and "age out" of the foster care system? Approximately 20,000 youth age out of foster care system each year, exiting the child welfare system when they reach age 18.

The transition from adolescence to adulthood can be difficult time for youth, but it's even more challenging for youth aging out of foster care--suddenly on their own at 18 without the safety net of a permanent family. On the Line with CWLA features adolescents currently in foster care and young adult alumni of the foster care system who will express their personal thoughts and feelings about aging out.

Wednesday, May 21
Happy Endings: Foster Family Success Stories


Our country has an ongoing need for foster parents. Unfortunately, foster parenting is often misunderstood and maligned by the negative portrayals of foster families in newspapers, movies, and television, which stigmatize both foster parents and foster children and severely hinder efforts to recruit qualified foster parents.

Contrary to these negative images, there are many stories about foster children who have grown up to become productive, successful adults because of the love and guiding influence of their foster parents. In a effort to dispel the misguided perceptions, On the Line with CWLA salutes foster families--unsung heroes who are making a difference in the lives of foster children.

Wednesday, May 28
A Conversation with Victoria Rowell


An estimated 12 million alumni from the foster care system live in the United States, representing all walks of life. Although a high percentage of youth leave foster care with many troubles and end up homeless, in mental health hospitals, or in prison, many former foster children have triumphed and become successful adults.

On the Line with CWLA engages in a one-on-one discussion with actress Victoria Rowell, who spent 18 years in foster care. Rowell is an award-winning actress of theatre, daytime soap operas (Drucilla Winters on The Young and the Restless), primetime television (Dr. Amanda Bentley on Diagnosis: Murder), and feature films, and a dedicated champion for foster children in America.

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 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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