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

   
   
Vol. 22, Issue 30: 8/10/2009   
Headlines

Health Reform Takes Priority in Recess Discussions

APA Releases Mental Health, Addiction Parity Guide for Employers

On the Line with CWLA Highlights Home Visiting

Letter Supporting Early Learning Fund Welcomes Local Organizations

FY 2010 Appropriations Status

CWLA Continues Survey on Prevention

New Report on TANF from Center on Budget and Policy Priorities

Webinar Explores Fostering Connections Act's Impact on Older Youth

Key Upcoming Dates for Congress



Health Reform Takes Priority in Recess Discussions

With both the House and Senate now in recess, members are back in their states and districts for the remainder of August. Many of their discussions and town hall meetings will center around the comprehensive health reform legislation that is being debated and is one of President Barack Obama's top legislative priorities.

Right before leaving for its August recess, the final House Committee with jurisdiction over health reform approved the House bill, H.R. 3200, by a vote of 31-28. The other two House Committees with jurisdiction separately approved H.R. 3200 on July 17. No Republicans on the Energy and Commerce Committee supported the measure, and five Democrats also voted against it: Rick Boucher (VA-9), Bart Stupak (MI-1), Jim Matheson (UT-2), Charlie Melancon (LA-3), and John Barrow (GA-12). During markup, Congresswoman Tammy Baldwin (D-WI) offered a therapeutic foster care amendment that was approved by voice vote. Congresswoman Baldwin's amendment provides a basic definition of therapeutic foster care and protects reimbursement for TFC by stating that nothing in the Medicaid statute prohibits Medicaid for paying for the treatment contained in TFC.

Many other amendments were approved, including one whereby the rates for a public option plan would be negotiated with health providers as opposed to being set at Medicare rates. Also approved as part of negotiations with fiscally conservative Blue Dog Democrats was an amendment to cut subsidies to low-income individuals seeking to purchase health coverage through the newly created exchange. Merging of the House bill will begin to occur over the August recess. House leadership is hopeful for a full House vote in September.

The Senate concluded their summer session last week and will be on recess for the remainder of August, returning to Washington after Labor Day. There are two committees in the Senate with jurisdiction over health reform, each of whom is crafting its own bill. The Senate Health, Education, Labor, and Pensions Committee passed its health reform bill on July 15. Six bipartisan members of the Senate Finance Committee met for weeks to develop its plan. Progress was made, but no legislative language was expected prior to their departure from Washington.

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APA Releases Mental Health, Addiction Parity Guide for Employers

The American Psychological Association Practice Organization (APAPO) released initial guidance for employers affected by enactment of the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008 (P.L. 110-343). Signed into law last October, the act requires group health plans which choose to offer mental health and addiction benefits and have 50 or more enrollees to provide those benefits on the same terms as other medical conditions. The law prohibits insurers from setting more restrictive financial requirements or treatment limitations on mental and addiction illnesses, requires any out-of-network benefits to be at parity, and permits stronger state laws to stand. Formal federal guidance on the parity act will hopefully be available this fall.

In its guide, the APAPO stresses the importance of the new law by detailing the severe cost of mental illness and substance abuse. It is estimated that 217 million days of work are lost each year due to productivity decline related to mental illness and substance abuse disorders, costing American employers at least $17 billion each year. Indirect costs to employers total anywhere from $79 billion to $105 billion per year. Among the many helpful action steps recommended for employers affected by the parity law are to equalize all financial requirements and treatment limitations for mental health with medical/surgical benefits; assure adequate access to a full range of settings including hospitalization, partial hospitalization, residential care and outpatient; eliminate office visit limits and/or hospital day limits on mental health services; use common deductibles and maximum out-of-pocket cost sharing; and equalize office copayments.

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On the Line with CWLA Highlights Home Visiting

The August 12 edition of On the Line with CWLA will highlight home visiting. The live online radio program is hosted by CWLA Vice President for Policy and Public Affairs Linda Spears, and provides a platform for CWLA member organizations, their staffs, partner organizations, 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.

This Wednesday, the two featured guests are advocates who will discuss the importance of home visiting and describe the efforts being made to ensure that federal funding is made available to deliver these critical services to children and families in need. Tune in to find out what Congress is doing to address home visiting, one of several child care and early childhood education initiatives proposed by President Obama to advance his zero to five initiative. There has been significant action in both the House and the Senate to include a home visitation initiative in health care reform.

To listen to On the Line with CWLA, visit Back to Headlines

Letter Supporting Early Learning Fund Welcomes Local Organizations

The National Women's Law Center is circulating a sign-on letter in support of the Early Learning Challenge Fund. National groups, including CWLA, have signed on in support and now the Law Center has decided to open the letter to state and local organizations, as well as national groups. The deadline for signatures is August 28, and groups can sign on by filling out an online form.

The Fund is included in the Student Aid and Fiscal Responsibility Act of 2009, H.R. 3221, passed in mid-July by the House Committee on Education and Labor. The focus of the legislation is to reform the way college loans are provided and financed, but Title IV of the bill creates an Early Learning Challenge Fund. The fund would provide an early down payment on President Obama's efforts to better coordinate services and support to the birth to age five population. One part of that effort is the home visiting legislation that is being debated as part of health care reform but another important effort is better coordination and greater funding between Head Start, child care, and state pre-K programs. The new Early Learning Challenge Fund would provide competitive grants to states to coordinate services and standards for and between those early childhood programs. Coordination is actually required as part of the state application and planning process.

The overall goal of the new initiatives is to better early learning standards across programs, enhance program review and monitoring, provide comprehensive professional development, strengthen support for parents who may use or enroll their children in one or more of the programs and to improve outcomes for children participating in these early learning programs. The legislation also directs the U.S. Department of Health and Human Services (HHS) and the Department of Education to jointly administer the program. The funding is set at $1 billion a year from 2010 through 2019. Funds are raised through the changes that the overall bill makes to the college loan process.

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FY 2010 Appropriations Status

When Congress returns after Labor Day there will be little more than three weeks to complete action on 2010 appropriations before the start of the new federal fiscal year. The House of Representatives has completed action on all 12 appropriations bills. The Senate, which follows the House in the appropriations process, has passed 4 of the 12 bills and has completed committee debate on all but the Defense appropriations. The Senate approved its version (Report 111-96) of the Departments of Labor, Health and Human Services, and Education (Labor-HHS) on July 30. The four appropriations bills approved by both the House and the Senate and ready for reaching a final conference agreement are Agriculture, Energy and Water, Homeland Security, and the Legislative Branch. Although the Senate has not approved a Defense Department bill they did act on the authorization bill which is a prelude to final appropriations action in that department.

There are no significant differences between the Senate and House versions of the Labor-HHS appropriations bill, with only minor differences found in education and in some of the health block grants. View CWLA's budget chart to see these differences. Overall, the Labor-HHS bills spend between $160 and $163 billion in discretionary dollars. The bills also provide $567 billion in mandatory funding, most of which applies to HHS and represents mandatory funding for Medicare and Medicaid. Part of the mandatory funding is for entitlements under Title IV-E foster care, adoptions assistance and subsidized guardianships. Title IV-E is expected to total $7.2 billion, an increase of $146 million from 2009. According to budget projections, $4.6 billion will be spent on foster care including administrative costs, $2.4 billion will be spent on adoption assistance including administration costs, and $49 million will be spent on the new subsidized guardianship program (kinship care). Adoption assistance is the fastest growing of the three, and the guardianship program is still in its start-up phase. All the cost projections (which are the same in both bills) for the Title IV-E programs are just projections since claims could increase or decrease according to need and the number of eligible children.

Both bills fund Head Start at $7.2 billion, an increase of $120 million, while child care remains at the 2009 level of $2.1 billion in discretionary funding. Child care receives an allocation of $2.9 billion in mandatory funds for a total of slightly more than $5 billion. Both Head Start and child care received $2 billion each as part of the stimulus package enacted earlier this year (the amounts are not included in these totals).

Both Labor-HHS bills also agree to President Obama's request to create two new innovations. The 2010 budget will include $20 million in competitive grants for programs that can reduce long term foster care placements. Additionally, both bills include $10 million in start-up application funds to create Promise Neighborhoods. These Promise Neighborhoods are modeled after the Harlem Children's Zone. The Children's Zone is a comprehensive school-based program. It seeks to improve a child's educational achievement by targeting children at an early age. It provides not just education support and services but also includes community-based services for the family and provides these services starting from pregnancy through pre-school.

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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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New Report on TANF from Center on Budget and Policy Priorities

The Center on Budget and Policy Priorities released a paper, Opportunities under the TANF Emergency Fund Created by the Federal Recovery Act, which examines the Temporary Assistance for Needy Families (TANF) opportunities available to states under this year's American Recovery and Reinvestment Act. The TANF Emergency Fund includes 80% federal funding for increased state caseloads and the caseload reduction credit provision. States can receive funding for 80% of the additional costs incurred if TANF caseloads rise. In addition, states have the ability to obtain the caseload reduction credit by using the base year of 2007 or 2008, instead of the prior fiscal year. Even if a state does not experience a rise in caseloads, they are still eligible for TANF Emergency Funds through the non-recurrent, short-term benefits and subsidized employment categories.

Funds can be used towards basic assistance, non-recurrent, short-term benefits, and subsidized employment. In addition, basic assistance can be applied to increase monthly TANF benefit amounts, disregard more earnings for TANF applicants or recipients, and provide supplements for working families outside of the regular TANF/Maintenance of Effort program.

A great way to stimulate the economy is to boost the incomes of low-income families, which can be achieved through the basic assistance category. Without a caseload requirement, non-recurrent, short-term benefits allow the states to offer families one-time payments, employment or TANF exit bonuses, and homelessness prevention or rapid re-housing funds. These emergency assistance programs can help families fight foreclosure, find new housing, and provide stability when first starting a job. Subsidized employment is another area for which states can receive funding. States can expand their subsidized employment program and/or receive 80% reimbursement of subsidized employment costs, which could include state work-study positions and paid work experience instead of volunteer positions.

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Webinar Explores Fostering Connections Act's Impact on Older Youth

The National Foster Care Coalition, in conjunction with the National Court-Appointed State Advocate Association, is hosting a webinar on the Fostering Connections Act provisions impacting older youth. This is a free, one-hour webinar review of the provisions for older youth, and an opportunity to discuss strategies to support and effectively advocate for older youth. Much of the discussion will be based on a new report on the frequently asked questions on these provisions, available through the link below.

The webinar will be held August 19 at 4 pm Eastern (3 pm Central, 2 pm Mountain, 1 pm Pacific).

Register for the August 19 session.

Download the FAQ Report.

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Key Upcoming Dates for Congress

August 1-September 7: House summer break
August 8-September 7: Senate summer break
October 1: Start of federal fiscal year 2010
October 15: Deadline for budget reconciliation instruction

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