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

   
   
Vol. 22, Issue 24: 6/22/2009   
Headlines

CWLA Posts White House Conference Survey on Prevention

HHS Releases Study of National Child Abuse Registry

More Home Visiting Legislation Introduced

HELP Committee Begins Health Care Debate, Finance Committee Delays

House Committee Release Draft Health Plan

Former Senators Release Bipartisan Health Reform Proposal

Cosponsors Needed on Bill to Protect Medicaid Rehab and TCM Services

Appropriations Update

House Education and Labor Gets New Ranking Member

Key Upcoming Dates for Congress



CWLA Posts White House Conference Survey on Prevention

Last fall, CWLA posted a short poll on our website asking what the potential White House Conference on Children and Youth should focus on. We received nearly one thousand responses. In the poll, CWLA asked individuals to select three top issues, with the understanding that all topics listed are important. CWLA then weighted votes according to which topics the voter listed first, second, and third. When we weighted the votes, prevention of child abuse and neglect was ranked by 16% of respondents as the number one priority--coming in ahead of other critical areas such as strengthening child protective services (14%) and youth transitioning out of foster care (11%). When we took away weighting, and counted all three votes by each polltaker regardless of priority ranking, 41% of respondents included prevention as one of their top three concerns. Not surprisingly, many participants indicated that all of the issues are of great concern and thus, were difficult to rank.

As a result and to continue the process, CWLA is going to use these survey findings to gather more information on each of the critical issues. We are asking you to take a new three-minute survey focused on prevention. Take the prevention survey and tell us what prevention services exist in your community. Are there waiting lists? How would you describe prevention?

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HHS Releases Study of National Child Abuse Registry

On Thursday, June 18, the Department of Health and Human Services (HHS) released a congressionally mandated study reviewing the feasibility of having a national child abuse registry. The study and the directive to create a national child abuse registry were included in the 2006 Adam Walsh Child Protection and Safety Act (P.L 109-248) which dealt with a number of issues involving child sex offenders.

The study, Interim Report to Congress on the Feasibility of a National Child Abuse Registry, concluded that there a number of significant challenges in creating one national child abuse registry. One of the report's conclusions is that the benefits of such a registry are largely unknown due to the differences among states. The study also points out that the 2006 law's requirements were general, and may create additional problems as a result. For instance, the law limits the information in a national registry to a perpetrator's name; the report points out the difficulty in listing common names and the confusion that could result. The report also points out that the original bill (H.R. 5219) to create a national registry was introduced as a free-standing bill. Normally, such a bill would have been reviewed by congressional committees that deal with laws such as the Child Abuse Prevention and Treatments Act (CAPTA) but the legislation did not go before those committees. Instead, the language was inserted into the Adam Walsh Act, which was crafted by the key criminal justice committees in the Congress.

While the logic behind such a registry seems strong and politically popular, the challenges of creating a national registry based on state systems would be a challenge. State child abuse registries are not like registries that track sex offenders. An informal discussion between CWLA and some states, and as the report documents, indicates that child abuse and neglect registries vary between their uses and how individuals are listed on such a registry. Individuals on such registries may not have broken a law and they may not have had an opportunity to appeal or challenge such a listing. In fact, the study states that in 2007 only 19% of substantiated cases of abuse and neglect involved a court action or petition. States may also have different definitions of neglect, different appeals process to remove one's name from the registry, different lengths of time a person is on the registry, and differences about court involvement. Some states do not have a registry and track families and persons in a different way. The HHS report includes a listing of states, what the state reports, the level of evidence, the expungement rules for taking names off, and the due process requirements.

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More Home Visiting Legislation Introduced

On June 16, Senators Robert Menendez (D-NJ) and Robert Casey (D-PA) introduced S 1267, the Evidence-Based Home Visitation Act of 2009. This bill would amend Title V of the Social Security Act to provide grants to establish or expand quality programs providing home visitation to low-income families. Similar to HR 2667, the home visiting bill that was introduced by Chairman Jim McDermott (D-WA), this bill would call for initial funding of $100 million in FY 2010, increasing to $700 million by FY 2014. There are quite a few differences between this bill and HR 2667. For one, the state match is not specified in S 1267; rather it is left up to the discretion of HHS. In addition, S 1267 does not describe the level of funding which would be allocated to models that adhere to the strongest evidence of effectiveness. Read the bill online: search under bill number S 1267 at http://thomas.loc.gov.

CWLA is pleased that legislation has been introduced in both the House and the Senate that would fulfill one of President Obama's zero to five early childhood initiatives. In addition, we anticipate that the Senate Finance Committee mark will contain a home visitation element, and we will continue to continue to track the progress as the House and Senate will still have to resolve the differences between their two proposals. To read a copy of CWLA's testimony on home visiting which expresses our support for HR 2667, the Early Support for Home Visiting Act, visit the Advocacy page.

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HELP Committee Begins Health Care Debate, Finance Committee Delays

Last Wednesday, the Senate Health, Education, Labor, and Pensions (HELP) Committee began marking up the Affordable Health Choices Act, the committee's legislation to reform our nation's health care system. The draft legislation would require individuals to have health insurance, unless they face hardship to do so, but also places responsibility on employers to offer health insurance. The HELP Committee would expand the Medicaid program to cover more uninsured individuals and would create an exchange whereby individuals could purchase insurance. The bill also suggests having a public plan in place, which has been opposed by some in Congress. A public plan would be a government-run or government-overseen plan that individuals could buy into as an alternative to private insurance. The mark-up did spark debate, as members expressed concerns over the bill's high cost estimate released by the Congressional Budget Office, and also over a lack of bipartisanship in drafting the bill.

The Senate Finance Committee delayed release of any details of their version of health reform legislation. Finance Committee Chairman Max Baucus (D-MT) hoped to decrease the cost of their bill in light of the high price tag associated with the Affordable Health Choices Act.

In the House, the three committees that share jurisdiction over health reform legislation--the Energy and Commerce Committee, the Ways and Means Committee, and the Education and Labor Committee--have been collaborating on legislative language and were aiming to have it out at the end of last week. The Energy and Commerce Committee will hold a series of hearings and panels this week. Last Wednesday, House Republicans provided glimpses into their alternate health reform plan. They would give individuals and small businesses tax deductions and tax credits to purchase insurance and would permit small businesses to band together to buy health coverage for their employees. They may also create a voucher that current Medicaid and Children's Health Insurance Program beneficiaries could use to purchase private health insurance.

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House Committee Release Draft Health Plan

Representatives of the three House Committees with jurisdiction over health care reform legislation provided a briefing on their health plan on Thursday, June 18. Called the Tri-Committee Health Reform Draft Proposal, the actual bill language was scheduled to be released on Friday. Staff from the House Ways and Means Committee, Energy and Commerce Committee and Education and Labor Committee emphasized the fact that the bill language was considered draft and that they were seeking feedback in the process. Broadly, the proposal would create an insurance market exchange where individuals and small businesses could go to shop for a policy. The exchange would include a public health insurance option. The proposal would also include changes to Medicaid, providing all individuals up to 133% of poverty coverage, with the ability to buy into Medicaid for individuals and families up to 400% of poverty. Employers would be required to provide coverage or contribute to an insurance fund while individuals, with some exception, would be required to purchase coverage. Credits to help subsidize the cost of insurance would be available. There would be insurance market reforms and minimum standards for all policies. Committee representatives indicated that the bill will deal with revenue-raising measures later, but this bill draft does include cost savings that are part of the way the committees expect to pay for the plan. All three committees will start hearings this week on Tuesday, Wednesday, and Thursday. Download the draft plan.

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Former Senators Release Bipartisan Health Reform Proposal

Former Republican Senate Majority Leaders Howard Baker and Bob Dole and Former Democratic Senate Majority Leader Tom Daschle released a proposal last week to reform our nation's health care system. The proposal, entitled Crossing Our Lines: Working Together to Reform the U.S. Health System, was formed over 18 months of work and was done in conjunction with the Bipartisan Policy Center. The project also involved outreach to health care stakeholders, public forms in various states, and personal discussions among the senators.

The proposal is organized by four "pillars." The first pillar is to promote high-quality, high-value health care, and suggests investing in health information technology, reforming provider payments in federal health programs, investing in health care workforce, and addressing racial and ethnic disparities, among other ideas. The second pillar is to make health insurance available, meaningful, and affordable. This would be done by reforming the markets, guaranteeing access to coverage regardless of health status, creating a network of state- or regional-level health insurance exchanges, and ensuring affordability by limiting out-of-pocket premiums and enhancing protection for Americans below 400% of the federal poverty level. The third pillar is to emphasize and support personal responsibility and health choices, while the fourth pillar focuses on developing a workable and sustainable approach to health care financing. Notably absent from the senators' bipartisan plan is a federally run or overseen public plan, which has become a source of contention in Congress. Instead, the senators would leave it to the states--granting them the option of implementing such a plan.

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Cosponsors Needed on Bill to Protect Medicaid Rehab and TCM Services

On June 9, Senator Debbie A. Stabenow (D-MI) reintroduced the Medicaid Services Restoration Act (S. 1217) that would protect vital Rehabilitative and Targeted Case Management (TCM) services for vulnerable populations, including children in the child welfare and foster care systems. Stabenow first introduced the legislation in the 110th Congress in response to a series of extremely restrictive Medicaid regulations. Even though some of the regulations are in the process of being rescinded, the legislation is necessary to clearly define the TCM options and to provide a transparent funding stream for therapeutic foster care (TFC), an evidence-informed and highly effective placement for children and youth with serious medical, psychological, emotional, and social needs.

S. 1217 would help protect the rehab and TCM options for vulnerable populations by enabling the child welfare and foster care systems to continue to draw down Medicaid dollars for important clinical treatment and/or case management as appropriate; permitting states to use reasonable and efficient payment methodologies for Medicaid rehab and TCM services; and allowing the use of multiple case managers when necessary. A critical and forward-moving piece of S. 1217 is its creation of a medical assistance option for therapeutic (or treatment) foster care. TFC provides services in a least restrictive, community-based environment for children with severe mental and behavioral health needs. Read a summary of the legislation on the Advocacy page.

Ask your senator to support S. 1217! Cosponsors are needed to help move this important piece of legislation forward. A House companion bill is expected in the near future.

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Appropriations Update

The House worked on passage of their first appropriations bill last week with the adoption of HR 2847, the Commerce, Justice and Science appropriation. The debate, however, may suggest how difficult the process may be due to a dispute over debating procedures. Action slowed when House Republicans expressed concerned over a requirement on filing amendments and as a result the debate on a relatively noncontroversial bill took up most of last week. At the same time, however, other appropriations committees were continuing to move legislation. Various subcommittees in both the House and Senate were talking action to pass the bills for Agriculture, Military Construction, Interior-Environment, the Legislative Branch, and the full Senate Appropriations Committee was passing the Homeland Security bill. The House schedule for appropriations calls for all 12 bills to be out of the House by the end of July. Labor-HHS bill is scheduled to be taken up for consideration in the subcommittee on July 8, with full committee consideration on July 14, and debate on the House floor between July 22 and July 24. Read CWLA's analysis of the President's budget.

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House Education and Labor Gets New Ranking Member

Congressman John Kline (R-MN) became the new ranking member of the House Education and Labor Committee. The elevation of Kline, who was listed tenth in Republican seniority on the Committee, came about when Congressman Buck McKeon relinquished his ranking member status to take on the Republican leadership of the House Armed Services Committee. The House Education and Labor Committee will be a key committee on issues of health care, child care, education, the Child Abuse Prevention and Treatment Act (CAPTA), and any early childhood initiatives the Administration proposes.

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Key Upcoming Dates for Congress

June 27-July 5: Congressional break
July 8: Target date for House subcommittees to pass Labor-HHS appropriations
July 15: Target date for House committee to pass Labor-HHS appropriations
July 22-24: Target date for House to debate and pass Labor-HHS appropriations
August 1-September 7: House summer break
August 8-September 7: Senate summer break
October 15: Deadline for budget reconciliation instruction

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