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

   
   
Vol. 22, Issue 35: 9/28/2009   
Headlines

Senate Approves Carmen Nazario as Head of Administration for Children and Families

Senate Finance Begins Markup of Health Reform; Therapeutic Foster Care Added

Georgetown Public Policy Institute Presents the Family Impact Seminar

Children's Bureau Announces Renewal of CWLA as National Resource Center

Appropriations Update: Continuing Resolution Likely

Key Upcoming Dates for Congress



Senate Approves Carmen Nazario as Head of Administration for Children and Families

On Tuesday, September 22, the Senate approved Carmen Nazario as the new head of the Administration for Children and Families (ACF). Her formal title is the Assistant Secretary for Children and Families. President Barack Obama nominated Nazario on May 5 and the Senate Finance Committee approved her appointment in July but in what has become an ever-slowing process, final hurdles were not cleared until mid-September. Nazario is not unfamiliar with the position, as during the second Clinton Administration term, she served as ACF's Associate Commissioner for Child Care and was later appointed ACF's Principal Deputy Assistant Secretary. Nazario brings with her a great deal of human service program experience. Before serving in the Clinton Administration, Nazario served as Secretary of Health and Social Services for the state of Delaware and was the Director of Social Services in Norfolk, Virginia and Loudoun County, Virginia. After leaving the Clinton Administration, Nazario was the Administrator of the Administration for Children and Families in Puerto Rico. More recently, she has served as an Assistant Professor at the Inter American University of Puerto Rico, where she taught social policy and coordinated the Social Work Practicum at the School of Social Work.

In a press statement praising the Senate action, HHS Secretary Sebelius said, "Carmen Nazario has a distinguished record of more than 40 years, working in human services at every level of government, as well as in the private and non-profit sectors. She has devoted her career to developing and implementing programs that promote the well-being of children and families, and she will build on that important work as Assistant Secretary for Children and Families." ACF is the critical department for child welfare and other vital children's programs. It includes not just the Administration on Children, Youth, and Families (ACYF) and its oversight of child welfare programs, but also the Office of Family Assistance (child care and TANF), the Administration for Native Americans (Tribal issues), the Office of Child Support, Office of Community Services (Social Services Block Grant), Office of Head Start, and the 10 regional HHS Offices.

Next up for child welfare is the position of Commissioner on Children, Youth, and Families at ACYF. Bryan Samuels, formerly from the Illinois Department of Children and Family Services, will come before the Senate Finance Committee for his confirmation hearing on Thursday, October 1. He was nominated on July 13 to fill that post. Three key positions for children's services and child welfare include the position at ACF, now held by Carmen Nazario and formerly filled by Wade Horn in the Bush Administration; ACYF, which is vacant but was formerly filled by Joan Ohl; and the head of the Children's Bureau, which is also vacant and was formerly filled by first Susan Orr and later Christine Calpin.

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Senate Finance Begins Markup of Health Reform; Therapeutic Foster Care Added

Shortly after releasing his Chairman's Mark, Chairman of the Senate Finance Committee Max Baucus (D-MT) and fellow committee members began marking up the America's Healthy Future Act. While not including an employer mandate, the Senate Finance Committee's health reform legislation would require individuals to purchase health insurance, with a penalty for those who do not. Hardship and religious exemptions would be available to individuals for whom purchasing health insurance is not feasible. Effective January 1, 2014, Medicaid would be expanded to parents, children, pregnant women, and childless adults under 133% of the federal poverty level, with the federal government helping states fund the expansion to newly eligible beneficiaries. Beginning in 2013 when the Children's Health Insurance Program (CHIP) reauthorization phases out, states would be required to provide children between Medicaid eligibility and 250% of the federal poverty level with services equivalent to the Medicaid early and periodic screening, diagnostic and treatment (EPSDT) services under Medicaid.

Prior to beginning actual markup, some modifications were made to the Chairman's Mark. For instance, an amendment was added that states before children are moved from CHIP to the exchange, the Health and Human Services Secretary must certify that children's benefits and cost sharing would be equal or better and that states have the capacity to provide EPSDT wraparound coverage. An amendment from Senator Debbie Stabenow (D-MI) was also included in the modifications; it provides a $200 million grant program for school-based health centers. Markup commenced, but moved fairly slowly last week. A therapeutic foster care (TFC) amendment offered by Stabenow was accepted that provides a basic definition of TFC and protects Medicaid reimbursement for the treatment contained in TFC. This amendment is identical to one offered and accepted in the House Energy and Commerce Committee. TFC provides intensive, individualized services in a community-based environment for children with severe mental and behavioral health needs. Several other amendments were expected to be offered that would help ensure comprehensive benefits for children and would help make coverage affordable for families.

Meanwhile, on the House side, on September 23, the House Energy and Commerce Committee approved additional amendments to the House health reform legislation, H.R. 3200. The panel had initially approved H.R. 3200 before the August recess, but according to an agreement, considered these largely non-controversial amendments after the fact. The package will be sent to the Rules Committee, who will decide whether or not to actually add the amendments. The House health reform bill has to be reconciled amongst the three Committees--Energy and Commerce, Ways and Means, and Education and Labor--and then brought to the House floor. The Senate Finance legislation, assuming it is approved by that panel, will have to be merged with the Senate Health, Education, Labor, and Pensions legislation that passed in the committee before the August recess. Differences between the bills can be seen on the Kaiser Family Foundation's helpful side-by-side chart, available online.

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Georgetown Public Policy Institute Presents the Family Impact Seminar

On September 21, the Georgetown Public Policy Institute (GPPI), the Center for Research on Children in the United States, and the Center for Juvenile Justice Reform hosted the Family Impact Seminar on the Nurse-Family Partnership (NFP) Program. David Olds, founder of NFP, addressed the audience on the how he came to develop the NFP model, the families served, the goals and outcomes of the program model, and the research behind NFP. Shay Bilchik, director for the Center for Juvenile Justice Reform at the GPPI, spoke to the importance of model fidelity as well as the need to encourage federal agencies to work together on home visitation. Sonja Nesbit, congressional staffer from the House Ways and Means Subcommittee on Income Security and Family Support, described the basic tenants of the home visiting legislation that is included in H.R. 3200, America's Affordable Health Choices Act of 2009. She described home visitation as a "common sense approach." The panelists discussed the positive goals and outcomes associated with NFP and other home visiting programs. All of the panelists echoed the importance of funding home visiting programs that are evidence-based. The GPPI also released a briefing report entitled Home Visitation Services as an Early Intervention Strategy.

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Children's Bureau Announces Renewal of CWLA as National Resource Center

Last week, the Children's Bureau announced the renewal and funding of several resource centers. Included in the announcement was renewal of CWLA as the National Resource Center for Child Welfare Data and Technology (NRC-CWDT). The mission of the NRC-CWDT is to assist state, local, and tribal child welfare agencies and the courts in improving outcomes for children and families through the use of data and information technology.

All of the Children's Bureau renewals and new grants begin effective September 30. In addition to the NRC-CWDT, several other centers were announced: The NRC on Organizational Improvement (University of Southern Maine), the NRC on Child Protective Services (ACTION for Child Protection), the NRC on Legal Judicial Issues (American Bar Association), the NRC on In-Home Services (The University of Iowa), the NRC on Permanency and Family Connections (Research Foundation CUNY), the NRC on Adoption (Spaulding for Children) the NRC on Youth Development (The University of Oklahoma), the NRC for Community-Based Child Abuse Prevention (Chapel Hill Training Outreach Project, Inc.), and the NRC for Tribes (Tribal Law and Policy Institute). The NRC for Tribes is the result of funding provided through the Fostering Connections to Success Act (PL 110-351).

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Appropriations Update: Continuing Resolution Likely

By week's end, the Senate was finishing up work on the sixth of 12 appropriations bills that make up the annual federal budget. The House of Representatives has completed action on all 12 appropriations bills. After both houses act, a conference report must be agreed to on any differences and then approved again by each house. The new fiscal year starts on October 1, and it seems like a continuing resolution (CR) will be required for approximately half the appropriations bills. Early indications were that the House would attach a CR to one of the final appropriations measures, the Legislative Branch Conference Report. The CR will extend funding to November 1, with funding for the one-month extension at current programs levels. The six appropriations bills passed by the Senate include: Energy and Water, the Legislative Branch, Transportation-Housing, Agriculture, Interior-Environment and Homeland Security. The Labor, Health and Human Services, and Education (Labor-HHS) bill has not been voted on yet by the Senate.

There are no significant differences between the Senate and House versions of the Labor-HHS bill, with only minor differences found in education and in some of the health block grants. 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 along with 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 a new $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 preschool.

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Key Upcoming Dates for Congress

October 1: Start of federal fiscal year 2010
October 12: Columbus Day
October 15: Deadline for budget reconciliation instruction
October 30: Target adjournment date for the House of Representatives (Senate TBA)
November 11: Veterans Day
December 11: Hanukkah Begins
December 25: Christmas Day

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