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

   
   
Vol. 22, Issue 26: 7/13/2009   
Headlines

Negotiations on Health Reform Intensify

Home Visiting Update

HHS Releases Initial CHIP Outreach Funds

Seven Plan to Extend Kinship-Guardianship Option

Briefing Examines Economic Costs of Child Poverty

Congress Picks Up Pace on Appropriations

CWLA Continues Survey on Prevention

Key Upcoming Dates for Congress



Negotiations on Health Reform Intensify

With its August recess looming, the House and Senate continue to work aggressively on legislation to reform the nation's health care system. President Barack Obama has indicated that he would like a health reform bill on his desk for signature in October, meaning that despite significant progress thus far, lawmakers have much to accomplish and much to negotiate before they return to their districts and states in August.

Last week, many meetings took place to try and move the process along. Vice President Joe Biden met with Senate Majority Leader Harry Reid (D-NV) and Senate Finance Chairman Max Baucus (D-MT), and Reid met with key Senate Republicans to ensure them that bipartisan talks may continue. The three House Committees working on health reform released their tri-Committee draft bill June 19 and have held hearings on their plans. The Senate Health, Education, Labor and Pensions (HELP) Committee has also released draft language and has been marking it up for the past couple of weeks. The final key Congressional player, the Senate Finance Committee, had not yet released actual legislative language at press time, but has indicated that its bill aims to cover 97% of Americans. All committees are looking to expand and improve the Medicaid program.

Many details remain to be resolved, but how to finance the package and whether the package will include a public health insurance option remain two of the largest areas of contention. Lawmakers are trying to keep the cost of health reform to $1 trillion over 10 years or fewer. It is likely that some of this money will come from savings from existing programs such as Medicare and Medicaid, with other possible financing mechanisms being taxing health benefits, tax increases for those making over $250,000, or increased taxes on sugary sodas and drinks.

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Home Visiting Update

On June 2, Congressmen Jim McDermott (D-WA), Danny Davis (D-IL), and Todd Platts (R-PA) introduced HR 2667, the Early Support for Families Act. The bill builds off of previous bipartisan legislation, the Education Begins at Home Act, as well as President Obama's $8.6 billion initiative to fund evidence-based home visitation programs. This legislation would establish a new state grant under Title IV-B of the Social Security Act to provide funding to states to create and expand early childhood home visitation programs.

On June 19, the three House committees with jurisdiction over health policy--Energy and Commerce, Ways and Means, and Education and Labor--unveiled draft legislation that included two home visiting elements. The first is an amendment to Title IV-B of the Social Security Act, which would provide grants to states for quality home visitation programs for families with young children and families expecting children. The language is very similar to HR 2667. In addition, the Medicaid and Children's Health Insurance Program Prevention section includes a provision for the optional coverage of nurse home visitation services, which also calls for an enhanced federal medical assistance percentage (FMAP) to cover the cost of these services.

Senators Robert Menendez (D-NJ) and Robert Casey (D-PA) introduced the Evidence-Based Home Visitation Act (S. 1267) on June 16. This legislation would amend Title V of the Social Security Act to provide grants to establish or expand quality programs providing home visitation for low-income pregnant women and low-income families with young children. CWLA will continue to follow the discussions on health reform, as we await the release of language from the Senate Finance Committee, which we anticipate will contain a home visitation component.

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HHS Releases Initial CHIP Outreach Funds

Last Monday, Health and Human Services (HHS) Secretary Kathleen Sebelius announced that $40 million in grants is available to help states enroll more eligible children in the Children's Health Insurance Program (CHIP) and Medicaid. CHIP exists in every state and provides health coverage to millions of children whose families earn too much to qualify for Medicaid but who are either not offered or cannot afford private coverage. CHIP was reauthorized earlier this year, with additional funding--including the recently announced $40 million--to improve the program and to provide needed health coverage to more low-income children. This is an initial allocation that will help states engage in outreach, with $60 million for further outreach efforts to be released later.

The following entities can apply for the CHIP/Medicaid outreach grants: states; local governments; Indian tribes, tribal consortia, or tribal organizations; federal health safety net organizations; national, state, local, or community-based public or nonprofit private organizations; certified faith-based organizations; and elementary or secondary schools. Electronic applications are due by August 6, while paper applications are due by August 10. For more information, visit the HHS website.

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Seven Plan to Extend Kinship-Guardianship Option

The Children's Bureau indicates that as of the end of last week, six states and the District of Columbia have submitted Title IV-E plan amendments to take the new kinship-guardianship option as provided for through last year's Fostering Connections Act (P.L. 110-351). The six states that have formally submitted plans to extend Title IV-E funding to kinship guardianship placements are: Maine, Missouri, Oregon, Pennsylvania, Rhode Island, Tennessee. The District of Columbia has submitted a plan as well. More states are expected to take the option, but as of late last week, have not submitted state plan amendments to the Children's Bureau.

The kinship-guardianship option became effective shortly after Fostering Connections was signed by President George W. Bush last October, but there is no timeframe or deadline for states to take the option. Considering that it has been less than one year since enactment of Fostering Connections, and that enactment coincided almost exactly with the severe economic downturn, the cautious pace is not that surprising. Some states may require legislative changes, and many are contemplating dramatic cuts in a number of human service programs. Also, pursuant to Fostering Connections, there are a number of actions states must take to use Title IV-E funds for the kinship placements including: outlining how they will assure the child and the relative's eligibility, meeting new case plan requirements, and meeting background check requirements. States are also awaiting guidance and clarification on some of the law's provisions.

The Fostering Connections Act has several provisions that take effect over the next several years. Both the tribal Title IV-E and the phase-out of the link between special needs adoption assistance and Aid to Families with Dependent Children (AFDC) begin in FY 2010, which begins on October 1. Starting on that date, tribal governments or consortia can apply directly to HHS to run their own Title IV-E foster care, adoption assistance and kinship programs. Also starting October 1, states will be able to use Title IV-E funds to cover all special needs adoptions for children 16 and older and special needs adoptive children who have been in foster care for five consecutive years. Currently, all special needs adoption assistance (as well as foster care and the new kinship care) are linked to whether or not a child was removed from a family that would have been eligible for the now non-existent AFDC as it existed on July 16, 1996.

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Briefing Examines Economic Costs of Child Poverty

On July 7, Senator Chris Dodd (D-CT) and Representative Jim McDermott (D-WA) cosponsored a briefing on the economic costs of child poverty. The briefing detailed the substantial economic costs associated with having over 13 million American children living in poverty.

Panelists from the Center for American Progress, First Focus, and the National Center for Children in Poverty presented data on poverty outcomes associated with a recession and shared knowledge of the effects of poverty on children and families. Recommendations included acknowledging the importance of sensible investments even in tough economic times; avoiding cutting and, instead, restoring programs for children who may be facing poverty due to a recession; and working to prevent children from coming into poverty in the first place.

On June 17, McDermott introduced HR 2909, the Measuring American Poverty Act of 2009. This bill would amend Title XI of the Social Security Act to provide for an improved method to measure poverty so as to enable a better assessment of the effects of programs under the Social Security Act. Dodd introduced similar legislation in the 110th Congress and reintroduction in the Senate is expected later this summer.

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Congress Picks Up Pace on Appropriations

Congress accelerated its work on Appropriations last week and seemed to be sticking to its tight schedule that may allow for completion of all appropriations by the start of the fiscal year on October 1. By week's end, at least half of the 12 appropriations bills had made it out of both Senate and House subcommittees. The House--which takes the legislative lead--has voted 10 of the 12 appropriations bills out of at least the subcommittee phase, with only the Defense and Transportation bills still unwritten. In addition to the Committee work, the full House debated and voted out its fifth bill, the Agriculture appropriations, late last week. Both the Senate and House Subcommittees were debating the Labor-Health and Human Services bills, which are expected to change little from the Administration's requests. The House plans to debate its bill on the House floor for a scheduled three-day period starting on July 22.

Leadership still hopes to pass all 12 appropriations bills by October 1. If they stick to that timetable, it will be the first time since October 1996 (FY 1997) that all the appropriations bills were passed and signed by the President by the start of a new fiscal year. Download and read CWLA's budget analysis.

On a related matter, there has been general, initial discussion of a second stimulus package with some members of Congress anxious about the current unemployment rate. For now however, a second stimulus seems unlikely considering that much of the current stimulus money has not yet been released at the federal level. Much of the $787 billion is tied to various individual programs that gradually draw down funding such as the reduced tax withholding for taxpayers, and benefit programs such as food stamps, Medicaid, and unemployment compensation.

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CWLA Continues Survey on Prevention

Last fall, CWLA posted a brief poll on our website asking what the White House Conference on Children and Youth should focus on. In the poll, individuals were asked to select three top issues. 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%). 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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Key Upcoming Dates for Congress

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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