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

   
   
Vol. 22, Issue 41: 11/9/2009   
Headlines

House Moves First on Health Reform

House Health Reform Impacts Vulnerable Children and Families

Groups Can Sign Up In Support of CAPTA

House Committee Responds to Families in Crisis

CMS Provides Guidance on Parity Provisions of New CHIP Law

Register for CWLA’s 2010 National Conference and Attend Advocacy Day!

Key Upcoming Dates for Congress



House Moves First on Health Reform

Late last Tuesday, House Democrats released what is known as a manager’s amendment containing mostly technical changes and some policy changes to the House health reform bill, the Affordable Health Care for America Act (H.R. 3962). This introduction triggered a 72-hour period promised to lawmakers, their staff, and the public so that there is sufficient time to review the bill before it is brought to the House floor. The manager’s amendment amongst other additions and modifications would require the secretary to establish a program consisting of grants, contracts, and cooperative agreements on mental health and substance abuse screening, brief intervention, referral and recovery services for individuals in primary health settings. The amendment would also establish more extensive Offices of Minority Health within existing agencies and departments.

Republicans offered an alternative health reform bill last week. The bill is significantly less expensive than H.R. 3962 and works to decrease health care costs, but would have essentially no impact on reducing the numbers of the uninsured. At press time, the House was hoping to hold a vote on H.R. 3962 this past Saturday.

The Senate is still awaiting a score (basically, a cost estimate) of its health reform legislation from the Congressional Budget Office. It is unclear when the Senate will be able to move forward to a vote.


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House Health Reform Impacts Vulnerable Children and Families

CWLA has produced a summary (http://www.cwla.org/advocacy/CWLA_Health_Reform_Bill_Summary.pdf) of many of the provisions contained in the House’s Affordable Health Care for America Act (H.R. 3962) that would impact access to health care for vulnerable children, youth, and families. The bill would for example--beginning in 2013--expand the Medicaid program to all individuals under 65 (including children, pregnant women, parents, individuals with disabilities, and childless adults) whose income level is below 150% of the federal poverty level (150% of FPL for 2009 is $16,245 for an individual and $27,465 for a family of three). The federal government would wholly pay for newly eligible individuals under this expansion for the first two years and starting in 2015, would pick up 91% of the cost.

The bill would also extend for six months the increased Medicaid and Title IV-E federal match contained in this year’s Recovery Act. This is essential to help ensure that in the current economic downturn, states have adequate support and do not have to resort to cutting vital health and IV-E services for vulnerable children. Also important are H.R. 3962’s provisions providing funding for home visitation programs and protecting reimbursement for therapeutic foster care programs.

Of significant concern to many children’s advocates is the fact that the bill would not reauthorize the Children’s Health Insurance Program (CHIP) after its current expiration date of 2013. CHIP children would be moved into a newly created health insurance exchange and it is unclear whether their benefits would remain as comprehensive.


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Groups Can Sign Up In Support of CAPTA

The National Child Abuse Coalition is circulating a group sign-on letter (http://www.cwla.org/advocacy/FY2011budget.pdf) in support of increased funding for the Child Abuse Prevention and Treatment Act (CAPTA) for federal fiscal year 2011. Groups interested in signing on to the letter have until the end of Monday, November 9, and can do so by sending an e-mail to Tom Birch, Legislative Counsel (bircht@earthlink.net).

Fall is a very critical time for presidential administrations when it comes to crafting the federal budget. Various negotiations are taking place between the Office of Management and Budget (OMB) and various departments including Health and Human Services (HHS). The sign-on letter asks the administration to provide significant increases for CAPTA. CAPTA includes three programs with grants to the states to develop innovative approaches to improve their CPS systems. CAPTA discretionary funds support state efforts to improve their practices in preventing and treating child abuse and neglect. These funds support program development, research, training, technical assistance, and the collection and dissemination of data to advance the prevention and treatment of child abuse and neglect. Finally, there are grants through the Community-Based Family Resource and Support Program that support efforts to develop, operate, and expand a network of community-based, prevention-focused family resource and support programs that coordinate resources among a range of existing public and private organizations.


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House Committee Responds to Families in Crisis

On Thursday, November 5, Representative Carolyn McCarthy (D-NY), Chairwoman of the House Subcommittees on Healthy Families and Communities, held a hearing to examine the best practices to prevent child abuse and neglect, as well as how to strengthen and improve services for families in crisis. Read CWLA’s testimony online (http://www.cwla.org/advocacy/PreventChildAbuseTestimony.pdf), and for a complete list of witnesses and testimonies, go to the Committee on Education and Labor’s website (http://edlabor.house.gov/hearings/2009/11/preventing-child-abuse-and-imp.shtml). The chairwoman opened the hearing with a welcome to the witnesses and an acknowledgement that abuse and neglect is a difficult subject to discuss especially because in too many cases, child abuse and neglect result in death. In their testimonies, the witnesses highlighted ways to prevent abuse and neglect as well as ways to improve responses to violence and abuse for families in crisis.

Dr. Rodney Hammond, from the Center for Disease Control’s Division of Violence Prevention, suggested promoting child health as one way to deter child maltreatment. He also made clear that while there are many factors that may agitate the daily stressors of parenting including substance abuse and economic stability, there is no “model” perpetrator of abuse and neglect. More importantly, parents need to know that they can seek help without fearing losing their kids. Dr. Carol Wilson Spigner, from the UPenn School of Social Policy and Practice, recommended that there be a special focus placed on workforce support and increased supervision for frontline workers, as well as an improved interstate referral system that would help keep children from falling through the cracks. Caren Kaplan, from the American Humane Association, highlighted the major tenets of differential response. Differential response offers families in crisis an alternative way to receiving services that does not make them feel alienated or demonized. As she pointed out, the majority of families that come to the attention of the child welfare system are low- to moderate-risk, and therefore are ideal candidates for differential response, which could possibly help reduce the number of families not receiving post services. Rob Sawyer, from the Olmsted County Community Services, also spoke about differential response and the positive impact it has had in the state of Minnesota.

Some of the members of the full committee were present at the hearing to thank the chairwoman for holding the important hearing and to inquire from the witnesses as to the challenges of addressing the issue and to seek recommendations for improvement within the system. Witnesses spoke to the challenges associated with limited CAPTA funding and the lack of the flexibility that states and other entities need to help facilitate prevention programs and strategies. Other recommendations included improving the Statewide Automated Child Welfare Information System (SACWIS), encouraging community partnerships, and supporting differential response, at the state and local levels, as a means to combating abuse and neglect.


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CMS Provides Guidance on Parity Provisions of New CHIP Law

On November 4, the Centers for Medicare and Medicaid Services (CMS) issued guidance (http://www.cms.hhs.gov/SMDL/downloads/SHO110409.pdf) on the mental health and substance abuse parity provisions contained in the recent reauthorization of the Children’s Health Insurance Program (CHIP, P.L. 111-3). In 2008, the Paul Wellstone and Pete Domenici Mental Health and Addiction Equity Act (P.L. 110-343) closed many loopholes and brought mental health and addiction benefits on par with medical benefits, if a group health plan of 50 or more enrollees chooses to offer mental health and addiction benefits. The CHIP reauthorization essentially extended this parity requirement to (1) CHIP programs that offer both medical/surgical and mental health or substance use disorder benefits and (2) to Medicaid if the state’s Medicaid agency contracts with one or more managed care organizations (MCOs) or Prepaid Inpatient Health Plans (PIHPs) to provide medical/surgical and mental health or substance abuse benefits. States will be held to a good faith compliance standard, and the guidance provides a contact person at CMS if anyone has questions.

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Register for CWLA’s 2010 National Conference and Attend Advocacy Day!

Registration is open for CWLA’s 2010 national conference, Children 2010: Leading a New Era. The national conference is a month earlier this year--January 24 to 27, 2010--so it is important to register soon! At the conference, more than 120 child and family experts will report on timely and important topics like adoption, foster care, technology, executive leadership, early childhood and mental health, juvenile justice, and residential services.

Advocacy Day will be held in the middle of the national conference, on Tuesday, January 26. CWLA’s Advocacy Day is the largest national advocacy event of the year for child welfare advocates and CWLA encourages all conference attendees to go to Capitol Hill and carry the message for the children, youth, and families you serve. Learn more about Advocacy Day (http://www.cwla.org/advocacyday/), and register for the national conference now--early-bird rates are still available through November 30 on the Conferences page (http://www.cwla.org/conferences/conferences.htm).


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Key Upcoming Dates for Congress

November 11: Veterans Day
November 25: Thanksgiving Day Break
December 11: Hanukkah Begins
December 18: Second CR Expires


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