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

   
   
Vol. 22, Issue 27: 7/20/2009   
Headlines

Health Reform: House, Senate HELP Committee Move Forward

White House Issues 2009 Children's Report: Child Poverty Increases

Carmen Nazario Moves Closer to Final Approval for HHS Post

Home Visiting Update

Baby Caucus Holds First Briefing

House On Schedule to Debate Labor-HHS Bill This Week

Subcommittee Holds Hearing on Youth PROMISE Act

Congressional Briefing Focuses on Post-Adoption Services

Landrieu Hosts Roundtable on Teen Pregnancy Prevention

CWLA Continues Survey on Prevention

Key Upcoming Dates for Congress



Health Reform: House, Senate HELP Committee Move Forward

On July 14, the three House committees with jurisdiction over health reform--the Energy and Commerce, Education and Labor, and Ways and Means committees--introduced their legislation to overhaul the nation's health care system. The bill, America's Affordable Health Choices Act (H.R. 3200), would place shared responsibility on individuals, employers, and the government to ensure that the vast majority of Americans have health coverage. Exceptions to the requirement would be available for individuals facing hardship and the smallest businesses, with other small businesses able to get a tax credit. Effective in 2013, Medicaid would be expanded by the House bill to cover all individuals falling below 133% of the federal poverty level ($14,400 for an individual). To cover more of the uninsured and provide choice, an insurance exchange would be created whereby individuals and small businesses could purchase coverage, with the option to buy a public plan. Certain benefits would be mandatory, including preventive services, rehabilitative and habilitative services, mental health and substance abuse services; and for children, oral, health, vision, and hearing services. Home visiting language is also included (see Home Visiting Update below). House Committees began marking up the legislation last week.

A day later, on July 15, the Senate Health, Education, Labor, and Pensions (HELP) Committee voted out its health reform legislation by a party-line vote of 13-10. The HELP Committee spent over sixty hours marking up its legislation and considered over 500 amendments. Like the House bill, the HELP Committee's reform legislation would place shared responsibility on individuals, employers, and the government to ensure that nearly all Americans receive health coverage. The HELP Committee hopes to expand the Medicaid program to cover individuals below 150% of the federal poverty level. The HELP Committee, like the House bill, currently includes a public health insurance option.

At press time, the third Congressional entity working on health reform--the Senate Finance Committee--had not released legislative language. The Finance Committee is expected to release a bill and begin mark up in the very near future. President Barack Obama has indicated that he would like a health reform bill on his desk for signature in October of this year. To meet that deadline, the Senate Finance and Senate HELP bills would have to be reconciled and then passed by the full Senate. After the House bill passes the full House, it would have to be conferenced (or reconciled) with the Senate bill in order to be sent to President Obama's desk for final signature.

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White House Issues 2009 Children's Report: Child Poverty Increases

On Friday, July 10, the Federal Interagency Forum on Child and Family Statistics released America's Children: Key National Indicators of Well-Being, 2009. This report details children's well-being in areas including economic circumstances, education, family and social environment, health care, and physical environment and safety. The report highlights some disturbing statistics with respect to child well-being, as well as some improvements and positive developments. Perhaps most troubling, albeit not very surprising, are the large racial and ethnic disparities that were reflected in the results. For example, black children had the highest rates of substantiated maltreatment reports. The poverty rate for black children was 35% and for Hispanic children, 29%. Black and Hispanic children were more likely to not have health insurance, not attend college, and to live with a single parent.

Poverty rates for children rose slightly from 2007 to 2008. In addition, 12.4 million children in America (17%) live in households that are food-insecure. For the second consecutive year, teen birth rates increased, following a long-term decline beginning in 1991.

Significant positive developments included increases in high school completion rates and the number of children with health coverage. There was also a slight decline in infants born prematurely or with low birth weights.

The report makes one thing clear: there is still a lot to be done to ensure quality well-being for all children. Therefore, the President's agenda is focused on giving more children access to a world-class education and closing achievement gaps, reforming health care so that it delivers quality care to more Americans while reducing costs for everyone, and building a vibrant, broad-based economy that can give families the stability of a good job and steady income. Visit the Forum's website for more information or to download the full report.

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Carmen Nazario Moves Closer to Final Approval for HHS Post

On Tuesday, July 14, the Senate Finance Committee took the first steps toward approving the nomination of Carmen Nazario to become the new head of the Administration for Children and Families (ACF). In her comments, Nazario emphasized three major area of focus as her priorities in the post: supporting families in achieving economic success, ensuring comprehensive child development, and improving the institutional capacity of ACF. As the chief of ACF, Nazario would be over a number of diverse and critical human services including child welfare, child care, Temporary Assistance for Needy Families (TANF), refugees, and child support.

In their opening remarks, both Chairman Max Baucus (D-MT) and ranking member Charles Grassley (R-IA) highlighted Congress's enactment of the Fostering Connections to Success Act (PL 110-351) and how important it is that the new child welfare law be implemented effectively. Baucus talked about the need to follow up that legislation with additional work on child welfare financing, prevention of child abuse, and more help for children who end up in foster care. Grassley talked about additional bipartisan efforts at reform. In regards to TANF reauthorization, Grassley called for a closer examination of the child-only caseload that exists in TANF, where an adult parent or guardian is present but not on assistance; he questioned whether these child-only families, which frequently include relative guardians, are the best structure to serve these kinship families or if they would be better served under child welfare.

The committee hearings were slowed down when several members had to shuttle across the hallway to the Senate Judiciary Committee's Supreme Court nomination hearing. As a result, members were allowed to submit questions and request answers in writing. The committee heard from three other appointees for the Treasury Department so it is unclear how long it will take for Finance Committee members to complete the hearing and then move the nominations to the Senate floor for what should be quick votes.

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Home Visiting Update

The America's Affordable Health Care Act (H.R. 3200) was released on Tuesday, July 14, and is now being marked up by the three respective committees. The bill included two home visiting elements. The first is an amendment to Title IV-B that 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 H.R. 2667, but the funding is significantly lower. Funding in H.R. 3200 for the IV-B amendment would provide roughly $750 million over five years. In fiscal year 2010, funding is proposed at $50 million and will increase to $250 million by FY 2014. The second amendment includes a provision for the optional coverage of nurse home visitation services under the Medicaid and Children's Health Insurance Program. In addition, it calls for an enhanced federal medical assistance percentage (FMAP) to cover the cost of these services.

In the Senate, the Health, Education, Labor, and Pensions (HELP) and Finance Committees have been working on separate health care reform bills. On Wednesday, July 15, the HELP Committee passed its health care reform bill by a vote of 13-10. It contains very limited home visitation language. In this bill, Part P of Title III of the Public Health Service Act is amended to provide grants to promote positive health behaviors for populations in medically underserved communities through the use of community health workers. These grants can be used to educate, guide, and provide home visitation services regarding maternal health and prenatal care. The Senate Finance Committee has yet to release its health care reform bill.

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Baby Caucus Holds First Briefing

On Tuesday, July 14, Representative Rosa DeLauro (D-CT) led off the inaugural event for the new Congressional Baby Caucus when she welcomed participants to a briefing on the challenges faced by infants and toddlers in military families. The new caucus hopes to focus greater congressional attention and policy on initiatives that can assist and support young children in the United States. DeLauro was joined by several colleagues including the Co-Chair of the caucus, Representative Denny Rehberg (R-MT). DeLauro indicated that she saw the new caucus as a way to focus greater attention on a range of important policy areas and programs, including those that deal with child welfare and child care, and early childhood development and education.

Tuesday's briefing featured panelists including Dr. Patricia Lester, an Assistant Professor of Child and Adolescent Psychiatry at UCLA. Participants also heard from military leaders who are assigned to oversee some of the needs of military families facing the stress of deployment and military service. There are an estimated 332,000 children under age 3 in families where at least one parent is on active duty. The presenters outlined a number of actions that could be taken to address some of the stress caused not just by injury or death in times of war, but also the stress that results from long parental separation. Among the policy solutions and actions recommended was the call for greater access and support for mental health services and treatment and continued, uninterrupted health care coverage. Other supports include access to high quality child care and greater focus and support for programs that can prevent child abuse and neglect such as family support initiatives, parental support and training and services to address the effect of trauma, grief and loss.

Additional founding members of the new caucus include Representatives Dennis Moore (D-KS), Patrick Kennedy (D-RI), Marcy Kaptur (D-OH), Stephanie Herseth Sandlin (D-SD), Tim Walz (D-MN), Vic Snyder (D-AR), Susan Davis (D-CA), Madeline Bordallo (D-GU), Lloyd Doggett (D-TX), Robert Brady (D-PA), Mike Ross (D-AR), John Yarmuth (D-KY), and Ileana Ros-Lehtinen (R-FL).

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House On Schedule to Debate Labor-HHS Bill This Week

At press time the House Appropriations Committee was debating an appropriations bill to fund the Department of Labor, the Department of Health and Human Services (HHS) and the Department of Education. That should allow the leadership to follow its plans to debate the bill, known as the Labor-HHS bill, on the floor for three days this week. Little is expected to change from what the President had requested. By the end of last week the House had debated and voted and passed 9 of the 12 appropriations bills, with the defense bill being the last one out of committee when the Appropriations subcommittee acted on that bill last Thursday. It looks as if the House will meet its target of passing all 12 bills before they break for the summer in August. The Senate should also have all 12 bils out of at least the Committee before the August break. For more, read CWLA's budget analysis.

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Subcommittee Holds Hearing on Youth PROMISE Act

On Wednesday, July 15, the Crime Subcommittee if the House Judiciary Committee held a hearing on the Youth Prison Reduction through Opportunities, Mentoring, Intervention, Support, and Education Act of 2009, or Youth PROMISE Act (H.R. 1064). The legislation awards grants to local governments and Indian tribes for evidence-based and promising practices for juvenile delinquency and criminal street gang activity prevention and intervention, especially for at-risk youth. The bill authorizes the National Institute of Justice to make three-year grants to public and private entities for the implementation and evaluation of innovative crime or delinquency prevention or intervention strategies.

Witnesses at the hearing included Marian Wright Edelman, founder of the Children's Defense Fund; Dr. Deborah Prothrow-Stith, Consultant, Spencer Stuart; Leroy D. Baca,
Sheriff, Los Angeles County; David B. Muhlhausen, Senior Policy Analyst, Heritage Foundation; and Tracy Velázquez, Executive Director, Justice Policy Institute.

Edelman testified that the legislation would mark a major step forward to stop the cradle-to-prison pipeline. Prothrow-Stith highlighted the much-needed focus in the legislation on delinquency prevention. Baca spoke about the fiscal benefits of investing in early intervention as the bill calls for. Muhlhausen focused on the evaluations required in the bill and urged the committee members to ensure effective assessments. Velázquez brought up examples of effective prevention programs, such as Functional Family Therapy and MultiSystemic Therapy.

The legislation, introduced by Representatives Bobby Scott (D-VA) and Michael Castle (R-DE), enjoys the bipartisan support of over 225 members of the House. Further action on the bill is expected soon.

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Congressional Briefing Focuses on Post-Adoption Services

On July 16, Voice for Adoption held a congressional briefing on the need for post-adoption services for families who adopt children from the foster care system. At the briefing, adoptees and adoptive parents shared their experiences with adoption. Parents shared their struggles with trying to secure financial and mental health services for their children. The adoption experts and advocates described some of the policies and supports that are in place for the families who seek to adopt children in the foster care system. For example, many of these families are eligible for support groups, crisis intervention, family counseling, and respite care, but so many do not know where to begin the process of accessing these much-needed services.

One recommendation was to urge Congress to reauthorize the Adoptions Opportunities Act, with special emphasis on strengthening the program so that post-adoption services are a priority for HHS funding. Throughout child welfare, there is an ever-present need for competent post-adoption services, complete with trained mental health providers who truly understand the dynamics of adoption as well as the impact that adoption and/or previous trauma may have on a child's overall development.

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Landrieu Hosts Roundtable on Teen Pregnancy Prevention

Senator Mary Landrieu (D-LA) hosted a panel roundtable discussion on the importance of preventing teen pregnancy and promoting healthy relationships among youth in foster care last Thursday. Amongst the panelists were representatives from Planned Parenthood, the National Campaign to Prevent Teen and Unplanned Pregnancy, National Foster Care Coalition, Chapin Hall, and foster care alumni. Most of the panelists addressed some of the self-esteem/self-worth issues that many teens in foster care face. The foster care alumni were all able to attest to the fact that their social workers never mentioned sexual education or sexual health with them. Some of the social workers in the room explained that while this may very well be the case in many social worker and client relationships, many times it is because the youth and social workers have never developed the rapport necessarily to delve into such personal matters. Also present were peer educators from Planned Parenthood. Many shared their experiences talking to and educating other youth about sex. One peer educator specifically mentioned that he found that youth are much more open to talking about sex with their peers and people who are closer to their age because they are able to trust and relate to them in ways that they might not be able to do with their foster parents, social workers, and other elders. Landrieu spoke about the importance of mentoring and the vital role that they can play in the lives youth in the foster care system. She also talked about the Foster Care Mentoring Act of 2009 (S. 986). This is a bill that she introduced this session that would support the establishment or expansion and operation of programs using a network of public and private community entities to provide mentoring for children in foster care. For updates on this bill, visit THOMAS and search for S. 986.

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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 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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