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

   
   
Vol. 22, Issue 16: 4/27/2009   
Headlines

Sebelius Approved by Senate Finance Committee, Vote Set For Tuesday

HHS Posts States' FMAP and IV-E Rates under Recovery Package

Budget Resolutions Should Be Settled Quickly

CWLA Weighs In on Home Visiting

Baucus and Kennedy Aim for June Health Reform Markup

CWLA Supports National Children's Mental Health Awareness Day, May 7

Fostering Connections to Success and Increasing Adoptions Act Information Update

Key Upcoming Dates for Congress



Sebelius Approved by Senate Finance Committee, Vote Set For Tuesday

Last Tuesday, the Senate Finance Committee voted 15-8 to approve Governor Kathleen Sebelius (D-KS) as the next Secretary of Health and Human Services (HHS). Two Republicans---Senator Olympia J. Snowe (ME) and Senator Pat Roberts (KS)---joined the Democrats on the panel in supporting Sebelius. Among the Republicans opposing her confirmation was Ranking Member Senator Charles Grassley (R-IA), who despite his nay vote indicated that he would not join a filibuster (which requires 60 votes). If all Democrats back her nomination, it seems that enough Republicans would support the governor, making her the next HHS head. Grassley had referenced her position on abortion as one of his concerns. An agreement was reached late Thursday to have a debate and vote on Tuesday, April 28 for the full Senate. If approved as head of HHS, Sebelius would oversee Medicare, Medicaid, most child welfare programs through the Administration for Children and Families, and other key programs including child care, Head Start, the Food and Drug Administration, the National Institutes of Health, the Office on Aging, the Surgeon General, and the Public Health Service. Her first big challenge, in addition to filling many open HHS positions, is to help lead the health reform debate.

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HHS Posts States' FMAP and IV-E Rates under Recovery Package

The Department of Health and Human Services (HHS) announced last Monday and published in the Federal Register on April 21 a chart of states' recalculated Federal Medical Assistance Percentages (FMAP) under the American Recovery and Reinvestment Act (ARRA, P.L. 111-5), the economic recovery package signed into law by President Obama in mid-February. ARRA contains temporary increases to states' federal matches for their Medicaid and Title IV-E Foster Care and Adoption programs to provide states relief and help them avoid having to cut vital services.

As long as a state meets the law's maintenance of effort requirement, the state receives a 6.2% increase to both programs and can receive additional percentage bumps for its Medicaid program if it has experienced significant unemployment, as determined by the statute. The FMAP adjustment is retroactive to October 1, 2008 and will last through December 31, 2010. Each state's FMAP adjustment will be re-calculated each fiscal quarter; the recently published FMAP rates are effective for the first two quarters of FY 2009 (from October 1, 2008 through March 31, 2009). The percentages in the notice apply to most medical services and medical insurance services only, not to administrative spending.

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Budget Resolutions Should Be Settled Quickly

Congressional leaders indicated quick action on a final budget resolution. The House and Senate approved their budget resolutions (H. Con. Res. 85 and S. Con. Res. 13) just before spring recess. The final votes in both houses were largely along party lines. The House bill is more closely aligned to the overall goals of President Obama's budget than the Senate bill. For FY 2010, the House resolution would allocate $7 billion less in discretionary spending than the President has asked for, while the Senate proposes $15 billion less.

CWLA sent two separate letters to Budget Conferees in support of four separate reserve funds: one on home visiting programs (see article below); one to implement finance reform in child welfare; one to advance a bill by Senator Blanche Lincoln (D-AR) that would assist in the recruitment of foster and adoptive parents; and the most significant, a reserve fund for health care reform. Download and read a PDF copy of the letter sent to the House and Senate Budget Committees in support of these reserve funds.

A reserve fund is a technical budget tool that can assist Congress in enacting changes to mandatory spending programs. It can allow for savings from one committee's jurisdiction to be used by another committee to fund a program under that second committee's jurisdiction. It can also assist in the transfer of savings from changes in the tax code to be used to fund a program. Inserting reserve funds into the budget resolution has become a popular way for members to highlight their support over an issue, but it does not mean that Congress will act on the issue. The resolution only lasts as long as the budget resolution (generally one year). There are more than 50 reserve funds in the Senate resolution.

The child welfare finance reserve fund was introduced by Senator Mary Landrieu (D-LA) and Senator Charles Grassley (R-IA) and calls for additional reforms in the way that child welfare services are financed, including allowing for funds to follow the child both before and after removal, as well as greater investment in a range of child welfare services. Senator Lincoln's reserve fund basically outlines the provisions of her legislation, the Resource Family Recruitment and Retention Act of 2009 (S. 410).

The health care reserve fund will be in the final resolution as the health care debate will take place. In addition to the slightly different spending levels, the major difference between the two is the inclusion of reconciliation instructions. The House resolution provides for a reconciliation process to pass health care and education reform. The Senate bill does not include reconciliation instructions.

A bill passed under the reconciliation rules would limit the hours of debate and would prohibit senators from using the filibuster to stop passage. Republicans in the Senate are opposed to using reconciliation, saying health reform must be bipartisan. Some Democrats, including the chairs of the Budget and Finance Committees, Senator Kent Conrad (D-ND) and Senator Max Baucus (D-MT), respectively, have voiced similar concerns. It is possible that negotiators will create a window to allow health reform to be debated under the normal procedure and then set a limit to allow for reconciliation to be used if a bipartisan agreement can't be reached at some point in the fall.

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CWLA Weighs In on Home Visiting

The Administration indicated in their budget significant new mandatory dollars for a new home visiting program. CWLA has been a supporter of the Education Begins At Home Act (HR 2343) passed by the House Education and Labor Committee last summer, which would establish a state grant program to fund a range of home visiting programs. New legislation has not yet been re-introduced in the House, but the Senate bill (S. 244) is sponsored by Senator Christopher Bond (R-MO) and Senator Patty Murray (D-WA). Since the Administration is still working on the specifics of their proposed FY 2010 budget, it is unclear exactly what their proposal would look like. Some advocates have been seeking funding for one model, Nurse Family Partnership (NFP), arguing it has the strongest research and evidence. CWLA and a broader coalition have been arguing for an approach that is not limited to one specific model, since the different models address different populations. Most states use several models depending on their needs of the communities and other factors, such as workforce capacity in an area or state. Download and read a PDF copy of the letter sent to the House and Senate Budget Committees in support of the home visitation reserve fund.

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Baucus and Kennedy Aim for June Health Reform Markup

Chairman of the Senate Finance Committee Max Baucus (D-MT) and Chairman of the Health, Education, Labor, and Pension Committee Edward M. Kennedy (D-MA) sent a joint letter to President Obama last Monday, April 20, to inform him of their desire to speedily move major health care reform legislation. These senators chair the two Senate committees with jurisdiction over health matters. Baucus and Kennedy stated in the letter that their respective committees hope to mark up legislation in early June. They intend for the bills to be "very similar" and reflect a "shared approach to reform" so that merging them and moving reform legislation forward to the Senate floor will not be too difficult. Also last week, the Senate Finance Committee began a series of roundtable discussions on health care reform. The roundtables will take place through April and May and will provide an open forum for Finance Committee members and health care policy and industry experts to evaluate reform options. Last week's roundtable topic was reforming the health care delivery system.

The House is also working on health reform. Three committees in the House share jurisdiction over changes to the health care system: Ways and Means, Energy and Commerce, and Education and Labor. The Chairmen of these committees, Charles B. Rangel (D-NY), Henry A. Waxman (D-CA), and George Miller (D-CA), have been communicating regularly and Congressman Roy Blunt (R-MO) appears to be taking the lead for the House Minority.

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CWLA Supports National Children's Mental Health Awareness Day, May 7

CWLA is joining with the Substance Abuse and Mental Health Services Administration (SAMHSA) to support the fourth annual National Children's Mental Health Awareness Day on May 7. Awareness Day is an opportunity for SAMHSA, SAMHSA-funded communities, and partner organizations such as CWLA to raise awareness of effective programs for children's mental health needs and promote positive youth development, recovery, and resilience.

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.

For more information about what your community and organization can do to support National Children's Mental Health Awareness Day on May 7, visit the website.

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Fostering Connections to Success and Increasing Adoptions Act Information Update

CWLA has been collecting information from all 50 states and the District of Columbia about their policies for youth in foster care over 18 years old. So far, information for 21 states has been completed and can be accessed from the resource section of the CWLA website and can be downloaded as a PDF here. The list includes information such as the maximum age a youth can remain in care, the legal arrangements for youth older than 18, whether reentry into the system is allowed, and the various living arrangement options. CWLA also took a special interest in higher education and how states are financially supporting foster care youth. Details about state tuition waivers and other state specific financial aid are listed. Additionally, information about how each state support youth in college over breaks is in included.

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Key Upcoming Dates for Congress

May 3: Federal agencies begin reporting on allocations of entitlement funds under recovery plan

May 15: Detailed agency financial reports under recovery plan released

May 15: Target date for House to begin passage of 12 appropriations bills

May 20: Competitive grants and contracts under recovery plan available

May 23-31: Memorial Day congressional break

June 27: Target date for House to complete work on appropriations

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