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

   
   
Vol. 21, Issue 39: 10/20/2008   
Headlines

Lame-Duck Session to Address Stimulus, Including Relief for States

Stabenow Introduces Legislation to Protect Medicaid for Vulnerable Populations

Budget by the Numbers: Larger Deficits Face Next President

On the Line with CWLA, 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



Lame-Duck Session to Address Stimulus, Including Relief for States

November to debate an economic stimulus package. This would be the second stimulus bill this year, but unlike the focus of the first one, which comprised tax rebates, this one will focus heavily on assistance to states and key vulnerable populations, and perhaps job-creating initiatives.

Last week, both Senate Majority Leader Harry Reid (D-NV) and House Speaker Nancy Pelosi (D-CA) talked about a package that may be as high as $150 billion. Such a bill likely would include some direct relief to the states, probably in the form of increased Medicaid reimbursements, an increase in the Low-Income Home Energy Assistance block grant, extended unemployment benefits, and job stimulus proposals.

Pelosi has asked key House committees to hold hearings on what might be included in a stimulus package. The key questions now are how large the package would be and whether it could pass and get President Bush's signature. Depending on the results of the election, a package could be debated and held for introduction in the next Congress, which convenes in early January, allowing the next President to sign the bill.

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Stabenow Introduces Legislation to Protect Medicaid for Vulnerable Populations

On September 26, Senator Debbie Stabenow (D-MI) introduced the Medicaid Services Restoration Act of 2008 (S. 3611). This legislation is aimed at protecting legitimate and vital Rehabilitative and Targeted Case Management (TCM) services for vulnerable populations, including children in the child welfare and foster care systems.

Rehab services help reduce physical or mental disabilities of children in care, often permitting children to stay in their communities rather than be placed in more restrictive settings. TCM services help Medicaid-eligible people connect with medical, social, educational, or other services.

The Bush Administration issued two restrictive regulations on these optional streams of care in 2007, but Congress--concerned about the rules' overzealousness and their likely negative impact on the Medicaid safety net and its needy beneficiaries--enacted a moratorium on the rehab and TCM rules until April 1, 2009 (P.L. 110-252). Even with the moratorium, ensuring these services will remain viable options for states is important.

Stabenow's bill would do that, while also addressing the Administration's concerns as expressed through its proposed regulations. CWLA worked closely with Stabenow's office and other child welfare, mental health, and disability organizations on the introduction of S. 3611.

Specifically, the bill would permit states to use reasonable and efficient payment methods for both rehab and TCM services, including fee-for-service or case or daily rates. In reaction to the regulations' troubling "intrinsic" or "integral" elements tests, the bill would permit Medicaid to reimburse rehab or TCM services provided by qualified providers in non-medical programs (including child welfare and foster care) and those that contract with non-medical programs, as long as the state or local agency is complying with in-place third-party liability rules.

States could use multiple case managers in certain instances, and the bill also clarifies that medical or surgical services for children in IMDs (institutions of mental disease, or inpatient facilities with more than 16 beds) are Medicaid reimbursable. Also significant is that the bill would create a new medical assistance category under Medicaid by which therapeutic foster care services could be reimbursed.

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Budget by the Numbers: Larger Deficits Face Next President

When the next President takes the oath of office in January, his Administration will inherit the largest federal deficit in U.S. history, making it even more challenging to fund key domestic priorities. Earlier this month, the budget deficit was set at $454 billion for 2008; the previous record was $412 billion in 2004.

This is a long way from the start of this decade, when we had a budget surplus of $236 billion for FY 2000. Much of the debate then focused on whether the country was in danger of paying the national debt down too soon and whether surplus funds should be used on tax cuts or to fund programs in certain domestic programs.

The deficit figures for next year are uncertain due to the economic relief package and any future stimulus package. The $700 billion loan package for economic relief is not necessarily a part of next year's deficit, depending on how it is allocated and counted by the Office of Management and Budget and whether it is even used. The $700 billion is in reserve until the Treasury allocates it in 2009 or later.

Much of the debate about how to reduce the federal deficit has focused on discretionary spending and proposals to freeze or cut such spending. Discretionary spending refers to funds Congress appropriates each year and does not include mandatory spending programs, such as Social Security, Medicare, Medicaid, and some veterans programs.

Cutting discretionary programs might be difficult, especially in view of last year's final official numbers. The final numbers for FY 2007 budget show that of $2.7 trillion in spending, $1.04 trillion was for discretionary spending. That discretionary total included $549 billion for the defense budget. The President has proposed in recent budgets that spending could be brought under control by cutting or freezing nondefense discretionary spending. He has also exempted homeland security spending from a freeze. Exempting homeland security and defense spending leave a little more than $400 billion from which to find budget cuts.

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On the Line with CWLA, Speaking for America's Children

On the Line with CWLA is a thought-provoking, interactive radio program focusing on subjects, stories, and strategies of special interest to child welfare policymakers, providers, and practitioners. The program, devoted solely to 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.

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.

Programming schedule subject to change.

This Week's Show

October 22
Web-Based Learning: A New Tool for Training Child Welfare Workers

Child welfare systems nationwide are under tremendous scrutiny regarding the qualifications and training of its workforce. Agencies struggle to provide relevant, quality training experiences for its workers and are looking for ways to meet training demands with limited resources. Many have turned to e-learning courses that staff can take anytime, anywhere, on either home or office computers. This week's show features discussion on domestic violence and other child welfare training Our guests: Andy Reitz, Senior Consultant, CWLA, and Lorraine Watson, President and COO, Essential Learning.

For more information on the show, visit www.cwla.org/newsevents/cwlaradio.htm.

Coming Shows

October 29
Adapting Adoption: A Look at Gay and Lesbian Adoption Rights



Half a million children live in foster care in the United States, and more than 100,000 foster children await adoption. States must recruit parents who are interested and able to foster and adopt children. Three states restrict gay, lesbian, and bisexual (GLB) individuals or couples from adopting. Several states have or are considering policies that would restrict GLB people from fostering. Recent government surveys demonstrate many lesbians and gay men are already raising children, and nearly two million GLB people have considered adoption. This week's guests include Susan Sommer, Senior Counsel, Lambda Legal, and Robin McHaelen, Executive Director, True Colors.

For more information on the show, visit www.cwla.org/newsevents/cwlaradio.htm.

On the Line with CWLA is a production of the Child Welfare League of America, Arlington, Virginia. Programming schedule subject to change.

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

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. CWLA is calling on Congress and the next President to reestablish this important policymaking tradition. The time to act is now. Your support and involvement are crucial.

You can support this effort by going to www.cwla.org/advocacy/whitehouseconf10.htm. There, you can sign on to support CWLA's call for a White House Conference in 2010, let you members of Congress know of your support, complete a survey about what areas you would like to see such a White House Conference focus on, see which members of Congress are cosponsoring the authorizing legislation for a White House Conference, learn how to get your board to pass a resolution supporting this effort, and more!

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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

November 4: Election Day
November 17: Senate returns to formal session
January 3, 2009: Start of 111th Congress
January 20, 2009: New President sworn in
March 6, 2009: Continuing resolution for FY 2009 expires


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