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

   
   
Vol. 22, Issue 5: 2/2/2009   
Headlines

CHIP Passes Senate

Economic Recovery: House Passes Bill, Senate Committees Act

SSBG Gets Senate Support

Update on Health Provisions in Economic Recovery Package

Budget Office Projects $800 Million More in Title IV-E

Center on Budget and Policy Priorities Calculates State Help

Senate Finance May Move on Daschle as HHS Secretary

New Solicitation of Comments on Tribal Regulations to Be Reissued

Visit Capitol Hill on Advocacy Day, February 24

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



CHIP Passes Senate

On January 29, after several days of debate, the Senate passed H.R. 2, reauthorizing the Children's Health Insurance Program (CHIP), by a vote of 66-32. CHIP provides health coverage to millions of children whose families earn too much to qualify for Medicaid but do not have access to private coverage. Congress passed two compromise bills in 2007 (H.R. 976 and H.R. 3963) that would have reauthorized and strengthened CHIP, but President Bush vetoed both measures. As a result of this gridlock, CHIP was extended through March 31, 2009, with sufficient funding to maintain current enrollment and avoid shortfalls (P.L. 110-173).

As passed by the Senate, H.R. 2 would reauthorize CHIP for four and a half years, with additional funding not only to maintain current enrollment of 6.7 million children, but to extend coverage to approximately 4 million additional children, many of whom are already eligible for the program.

Like the bill that passed the House of Representataives on January 14, the Senate bill improves CHIP's financing structure and establishes a pediatric quality initiative. During Senate Finance Committee markup, an amendment was added to the Senate package that would, like the House bill, provide states with the option to eliminate the current five-year waiting period for legal immigrant children and pregnant women, granting this population immediate access to much-needed health care services through Medicaid and CHIP. On the Senate floor, an amendment was offered but failed that would have required states to cover 95% of citizen children before offering CHIP coverage to legal immigrant children. A Republican substitute bill offered by Senate Minority Leader Mitch McConnell (R-KY) also was rejected.

Although there are some differences between the House and Senate bills, the House leadership was indicating it would avoid a conference committee and instead just approve the Senate bill. That could result in President Obama signing the legislation into law as early as next week. Speedy reauthorization and expansion of CHIP is seen by many as a significant step toward insuring all children.

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Economic Recovery: House Passes Bill, Senate Committees Act

The economic stimulus bill, the American Recovery and Reinvestment Act (ARRA, H.R.1), continued its move through Congress last week on several different fronts. The full House debated and approved its version by a vote of 244-188. The lengthy floor debate took place after President Obama visited both House and Senate Republicans. Despite this action by Obama, however, all House Republicans voted against the package; 11 Democrats also voted against it.

The total House package is $819 billion, slightly less than earlier projections. Of that, $275 billion is for tax reductions. The spending and taxes span two years. Perhaps the most significant part of the proposal for child welfare is the inclusion of a temporary boost to Title IV-E (foster care, adoption assistance, and kinship care) and Medicaid reimbursements to states. States would receive matching funds based on the Federal Medical Assistance Program rate. This rate would increase by 4.9% under the House bill and 5.6% under the Senate bill by; in both cases, the increase would be retroactive to October 1, 2008, and last until December 31, 2010.

While the House voted, the Senate moved to full floor debate at the end of the week, after the Senate Finance and Appropriations Committees marked up and approved their respective portions the Senate Bill, S. 1. The Senate bill totals $888 billion. Unlike the House bill, the Senate version would increase the Social Services Block Grant (SSBG) by $400 million, a significant development, since CWLA has been working in coalition with other groups to boost SSBG as a way to increase support for child protection and the nonprofit community. The next two articles focus on other key aspects of the recovery proposal.

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SSBG Gets Senate Support

The Senate's economic recovery bill would boost SSBG by $400 million, with a requirement that funds be released within 60 calendar days after approval of the legislation. The bill directs funding to be allocated to states on the basis of unemployment. The Senate report indicates the addition of SSBG funding would assist local nonprofits deliver critical services.

SSBG is usually distributed to states on a relatively straight population formula, since it covers a range of populations and services. In 1983, during another severe recession, Congress approved SSBG funding increases, and dollars were distributed half by the general formula, one-third based on the number of unemployed, and the remaining one-sixth based on whether a state's unemployment rate was above 9.4% in a six-month period.

As cochair of the SSBG Coalition, CWLA has been promoting increases in SSBG as a way to address both the increased need for child protective services and to assist the nonprofit community. Year after year, SSBG is the single largest source of funding for child protective services, contributing $250 million to $300 million a year--far exceeding the $27 million provided through the Child Abuse Prevention and Treatment Act. SSBG is also a vital source of support for a range of senior citizen services, including senior meals and elder abuse programs. Another large category of support is services for individuals with disabilities. SSBG also tends to supplement a large number of nonprofit services.

Although some states do break out how SSBG supplements other funding sources, including the nonprofit community, the annual reports don't generally list such information. In the 2003 SSBG annual report, HHS surveyed states to determine what percentage of each state's SSBG-funded services were provided by private providers, by public providers, or a combination of the two. The 38 states responding indicated that in all 29 categories of services, at least some were provided by a combination of public and private providers. In some instances, such as special services for those with disabilities, states used only private providers.

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Update on Health Provisions in Economic Recovery Package

Several important health care provisions are contained in the House and Senate versions of ARRA. Both versions include a temporary increase to the Federal Medical Assistance Percentage (FMAP) for state-run Medicaid programs. All states would receive a retroactive increase beginning October 1, 2008, through December 31, 2010. The House version (H.R. 1) would increase all states' FMAP by 4.9%, whereas the Senate bill (S. 1) would increase states' FMAP by 5.6%.

For states to receive the FMAP increase, their Medicaid eligibility rules and procedures must be as they existed on July 1, 2008. States could, however, still increase cost-sharing or cut benefits or provider rates. States with large increases in unemployment would be eligible for additional FMAP increases.

While marking up the bill, the Senate Finance Committee accepted an amendment by Senator Jeff Bingaman (D-NM) whereby 80% of the Medicaid money would be a flat-rate increase in reimbursement to all states, while 20% would be divided among states based on economic situation. The Senate's original breakdown was 60-40. and the House follows 50-50.

The House's recovery package would extend the moratoria on six Medicaid regulations, including rehab and TCM, to June 30, 2009. The Medicaid regulation pertaining to outpatient hospital services would also be put under a moratorium until June 30, 2009. The Senate's package, at press time, did not address the regulations. Before the House vote, a provision was dropped that would have allowed states to provide family planning services to low-income women without first having to obtain a waiver.

The House package provides a new option for states to cover temporarily any of the following populations, with 100% federal government financing of the new Medicaid category through December 31, 2010: individuals receiving, but who have exhausted, unemployment benefits; individuals receiving food stamps but who are not otherwise eligible for Medicaid; and individuals in families below 200% of the federal poverty level. The person must have exhausted his or h er unemployment benefits or lost his or her job between September 1, 2008, and December 31, 2010. The Senate does not include such a state option.

Finally, both the House and Senate versions include a modification of COBRA to allow individuals who have lost their jobs between September 1, 2008 and December 31, 2009, for reasons other than gross misconduct, and who worked at businesses of 20 or more employees, to continue their health coverage. The individual would be responsible for only 35% of the premium, and the government would subsidize the remaining 65%. This continuance could last up to 12 months past the involuntary termination and would terminate upon an offer of new employer-sponsored coverage.

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Budget Office Projects $800 Million More in Title IV-E

The Congressional Budget Office (CBO) has estimated the FMAP increase for Title IV-E programs will cost a total of $800 million from October 1, 2008, through December 31, 2010. Roughly $350 million of that would be for each of the first two years, and $100 million for the last quarter of calendar year 2010. Some of the funding could be drawn down in later years if states made later adjustments on old claims.

As always, the CBO projection is an estimate of the costs. In the case of an entitlement such as Title IV-E foster care, adoption assistance, and kinship care, the numbers could turn out higher or lower, depending on the number of eligible children in the state.

Both ARRA bills (H.R. 1, and S. 1) now include an increase in the FMAP for Title IV-E. Unlike the Medicaid FMAP increase, the FMAP increase does not include an additional adjustment based on a state's unemployment. The FMAP increase in applies to the maintenance payment in foster care and the assistance payment in adoption assistance. Generally, a state could examine what it is drawing down in these areas and adjust it upward by the 4.9% or 5.6% totals.

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Center on Budget and Policy Priorities Calculates State Help

On January 22, the Center on Budget and Policy Priorities (CBPP) released a report on the economic recovery package detailing state-by-state estimates of key provisions affecting low- and moderate-income individuals. For each of the proposals in the legislative package, the report includes a short description of the proposed policy and the methodology for CBPP's state estimates. Programs highlighted include FMAP, child care, the child tax credit, and food stamp/supplemental nutrition assistance. View a copy of the full report.

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Senate Finance May Move on Daschle as HHS Secretary

Former Senate Majority Leader Thomas Daschle (D-SD) moved quickly through the Senate Health, Education, Labor, and Pensions Committee's January 8 hearing on his nomination to become Secretary of the U.S. Department of Health and Human Services (HHS), but the Senate Finance Committee has not yet scheduled its hearing. Due to the broad responsibilities included in HHS, the designee for its HHS secretary goes before both committees.

HHS includes not just the Administration for Children and Families (ACF) but the Centers for Medicaid and Medicaid Services, the National Institutes of Health, the Food and Drug Administration, the Surgeon General, and many other human service and health agencies.

Senate Finance Chair Max Baucus (D-MT) suggested last week that his committee now has the information it requires, so a hearing could occur in a few days. The President has 15 cabinet positions to fill.

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New Solicitation of Comments on Tribal Regulations to Be Reissued

ACF will reissue a recent call for comments on the new tribal provisions of the Fostering Connections Act (P.L. 110-351). The original solicitation for public comment on the new tribal Title IV-E provisions were published prematurely in the Monday, January 26, Federal Register. HHS is required to issue regulations on at least some parts of the new law that would allow tribal governments or consortia to apply for and run their own foster care, adoption assistance, and kinship care programs. Future solicitations and comments will help inform how tribes apply and carry out their new programs. This tribal option becomes effective October 1, 2009 (FY 2010). HHS is expected to reissue the solicitation within a few days or weeks.

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Visit Capitol Hill on Advocacy Day, February 24

CWLA will again offer round trip bus rides to Capitol Hill on Advocacy Day--February 24. CWLA's National Conference, Children 2009: Children Today...America's Future, February 23-25, will provide attendees with one of the first opportunities to come to Washington under President Obama and the new 111th Congress. This will be the first Advocacy Day since the opening of the new Capitol Hill Visitors Center.

CWLA members and other conference participants are strongly encouraged to go to Capitol Hill on Tuesday February 24 to talk to their members of Congress and ask them to support the call for the White House Conference on Children and Youth. Advocacy Day is also a wonderful opportunity for CWLA members to talk to their elected officials about the challenges in their state budgets and their effect on children and families.

This will be an energizing conference and one of the most important advocacy events for child welfare in 2009. Register online at www.cwla.org/conferences/ShowConference.asp?CONF=NATIONAL&YEAR=2009.

For more information about Advocacy Day, email Cristina Fahrenthold at cfahrenthold@cwla.org.

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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

February 4
Helping Foster Youth Make A Successful Transition To Independent Adulthood


Coming Shows

February 11
The Link Between Juvenile Justice & Child Welfare: The Child Welfare/Juvenile Justice Systems Integration Initiative


February 18
A Conversation with Judge Lynn Toler, author of My Mother's Rules: A Practical Guide to Becoming an Emotional Genius


February 25
Rerun--A Conversation with Ashley Rhodes Courter...The Triumph Over Horrifying Treatment In Foster Care


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 your 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

February 2: FY 2010 Budget Released, Self-imposed Congressional deadline to complete recovery legislation
February 16: Presidential/Congressional deadline for completion of recovery legislation
February 16-20: Presidents Day Break
February 23-25: CWLA National Conference
March 6: Continuing resolution for FY 2009 expires
April 6-17: Spring recess


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