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

   
   
Vol. 22, Issue 44: 12/7/2009   
Headlines

Senate Begins Debate on Health Reform

New Bills Address Education of Foster and Homeless Children

GAO Examines Evaluation Methods

Juvenile Justice Legislation Advances

Celebrating National Adoption Day's 10th Anniversary

Medicaid FMAP Rates for FY 2011 Published

SAMHSA Administrator Confirmed

Combined Federal Campaign Ends December 15

Register for CWLA's 2010 National Conference!

Key Upcoming Dates for Congress



Senate Begins Debate on Health Reform

Last week, the Senate began debating its comprehensive health reform bill, the Patient Protection and Affordable Care Act (H.R. 3590), and it quickly became clear that divisive issues remain and weekend work will be necessary to try and meet the Democrat's target of a Senate vote before Christmas. Democrats need 60 votes to pass the bill and will spend the next few weeks working diligently to reach that count.

Effective January 1, 2014, the Senate's health reform bill would expand the Medicaid program to cover all individuals below 133% of the federal poverty level (FPL), with the federal government wholly paying for newly eligible individuals from 2014-2016. The Senate bill currently maintains Medicaid and Children's Health Insurance Program (CHIP) coverage for children above 133% FPL through fiscal year 2019, with states receiving a more enhanced match for CHIP-financed children. No new funding is provided for CHIP past its current expiration date of September 30, 2013, and children in stand-alone CHIP programs would begin receiving coverage through the newly created exchange. Senator Bob Casey (D-PA) introduced an amendment that would fund CHIP through 2019, streamline enrollment, and provide $50 million in annual grants for outreach to enroll eligible children. A report would also have to be conducted by 2016 to determine whether CHIP children's benefits would remain as comprehensive in the exchange.

The home visiting provision remained in the Senate bill. Unfortunately, the therapeutic foster care provision included in the House health reform bill and in the Senate Finance Committee bill was dropped, but efforts are being made to re-insert it. The merged Senate bill does include several provisions that would help vulnerable children and youth though, including providing Medicaid coverage for youth formerly in foster care for six months or longer who are not otherwise eligible for Medicaid up to the age of 25. This provision would take effect January 1, 2019.

The House passed its health reform bill (H.R. 3962) on November 7. Several differences exist between the House and Senate bills; a side-by-side comparison chart is available online. Another important difference is that the House bill would extend the Medicaid and IV-E FMAP increase included in the recovery package for two quarters--through June 30, 2011--but the Senate currently contains no such provision.

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New Bills Address Education of Foster and Homeless Children

Shortly before the Thanksgiving break, Senators Al Franken (D-MN) and Patty Murray (D-WA) introduced companion legislation to address educational access for children in foster care and homeless children and youth. The Fostering Success in Education Act of 2009, S. 2801, introduced by Franken, would create a version of the McKinney-Vento program but apply it to children in foster care. The Educational Success for Children and Youth Without Homes Act, S. 2800, introduced by Murray, would reauthorize the McKinney-Vento education program.

The Franken bill would require some of the same mandates on the state education and local education agencies that were enacted on child welfare agencies in 2008 as part of the Fostering Connections to Success Act (P.L. 110-351). The legislation requires child welfare agencies to keep children placed in foster care in their current schools when it is in the child's best interest. When staying in their current school is not in the foster child's best interest, then the child welfare agency must make sure that the child gets immediate enrollment in a new school. The Fostering Connections to Success Act also allowed states to draw down Title IV-E foster care maintenance funds to cover the cost of transportation if the child is Title IV-E eligible (approximately 211,000 out of 494,000 foster children in 2007). The initial challenge to the changes enacted by the Fostering Connections to Success Act is that the mandate is on the child welfare agency and those agencies do not control school enrollment policies. In some instances, local education agencies are unaware of the 2008 change.

The Franken bill also creates a new program similar to McKinney-Vento that would provide funding to facilitate cooperation between the child welfare and education agencies. States could apply for funding as long as they submitted collaborative plans drawn up by the state education and child welfare agencies. The plans must address, among other items, how the law will be enforced, an analysis on the barriers to education for children in care, detailed procedures for making school selection decisions, procedures to address transportation barriers and how they will be funded, how records will be transferred, how disputes will be resolved, how critical stakeholders are involved and will continue to be involved, and several other requirements.

CWLA has been working with Senator Franken and we support the legislation and its extension of the requirements now in child welfare law to education law. The bill, which makes most of its changes through federal education law, would also amend Title IV-E to direct the child welfare agency to have a designated person to address education issues, and to offer assurances on cooperation with the education agencies. It also contains a more controversial provision to require that the child welfare agency pay for transportation costs if necessary.

The Murray bill would reauthorize and strengthen the existing McKinney-Vento Education for Homeless Children and Youth program by making changes to how Title I, Part A education funding homeless set asides are determined, expanding access to summer school and before and after school programs for homeless children, addressing graduation barriers and school credit issues for unaccompanied youth, and improving access to preschool programs for homeless children. The bill also increases the authorization level for transportation costs and allows the use of Title I, Part A funding for transportation costs for homeless children. The McKinney-Vento Education for Homeless Children and Youth has been in existence for 22 years. It is reauthorized as part of the reauthorization of the Elementary and Secondary Education Act (No Child Left Behind). Congress is expected to start debate on the education reauthorization at some point next year.

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GAO Examines Evaluation Methods

There is a great deal of contention among policymakers, researchers, advocates, and practitioners regarding the reliance on evidence gathered from randomized control trials (RCT). The greatest disagreement comes from the belief that majority funding for interventions should be given to programs that have been evaluated using RCT's. In 2008, the nonprofit, nonpartisan Coalition for Evidence-Based Policy established the Top Tier Evidence initiative, to assist Congress and the executive branch in identifying interventions that meet the top tier evidence standards. Subsequently, the Government Accountability Office (GAO) looked into the initiative and was specifically asked to examine four areas: (1) the validity and transparency of the Coalition's process, (2) how its process compared to that of six federally supported efforts to identify effective interventions, (3) the types of interventions best suited for assessment with randomized experiments, and (4) alternative rigorous methods used to assess effectiveness. GAO reviewed documents, observed the Coalition's advisory panel deliberate on interventions meeting its top tier standard, and reviewed other documents describing the processes the federally supported efforts had used.

In addition, literature reviews on evaluation methods were conducted and experts were consulted on the use of randomized experiments. One consistent finding was that the credibility of the method of evaluation (regardless of the method of choice) relies on how well the method was carried out, including how well the studies' designs rule out competing causal explanations. Furthermore, an evaluation must be able to control exposure to the intervention and ensure that the treatment and control groups' experiences remain separate and distinct throughout the study.

The GAO report concluded that requiring evidence from randomized studies as the only proof of a program's effectiveness would likely exclude many potentially effective and worthwhile practices; that reliable assessments of evaluation results require research expertise but can be improved with detailed protocols and training; deciding to adopt an intervention involves other considerations in addition to effectiveness, such as cost and suitability to the local community; and that improved evaluation quality would help identify effective interventions.

The GAO report, Program Evaluation: A Variety of Rigorous Methods Can Help Identify Effective Interventions, is available for download.

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Juvenile Justice Legislation Advances

On Wednesday the House Judiciary Committee approved the Youth PROMISE Act, 17 to 14. This legislation (H.R. 1064/S. 435) takes a major step towards establishing a nationwide continuum of evidenced-based prevention and intervention programs for at-risk youth and will greatly reduce crime.

The Youth PROMISE Act calls for the implementation of evidence- and research-based strategies to reduce gang violence and crime. Under the act, communities facing the greatest youth gang and crime challenges will form a local council to develop a comprehensive plan for implementing intervention strategies. This council will include representatives from law enforcement, court services, schools, social service, health and mental health providers, and community-based organizations, including faith-based organizations. These strategies will be targeted at young people who are at-risk of becoming involved, or already involved in, gangs or the criminal justice system to redirect them toward productive and law-abiding alternatives.

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Celebrating National Adoption Day's 10th Anniversary

In honor of the 10th anniversary of National Adoption Day, Health and Human Services Secretary Kathleen Sebelius, Senator Mary Landrieu (D-LA), and Representative Jim McDermott (D-WA) participated in a National Adoption Day Ceremony in Washington, DC. Although, National Adoption Day was officially recognized this year on Saturday, November 21, participants gathered on Friday, November 20, to celebrate. Participants included individuals touched by adoption, including families with adopted children, as well as those waiting to be adopted, adoption advocates, and others.
National Adoption Day began in 2000 when a judge in Los Angeles opened his courtroom on a weekend in an attempt to address the problem of backlogged adoption cases. This year, an estimated 4,500 adoptions were set to be finalized across the United States on National Adoption Day. However, as Sebelius pointed out at the ceremony, while this is a great day to celebrate families coming together, it is also a day to draw attention to children who do not have permanent homes. With just under half a million children who are in foster care and roughly 130,000 waiting to be adopted, there is much more work to be done.

The Fostering Connections to Success and Increasing Adoptions Act of 2008 was indeed a start but more efforts are needed with regards to coordination in the adoption process as well as recruitment of adoptive parents and post-adoption services, and workforce recruitment and retention.

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Medicaid FMAP Rates for FY 2011 Published

On November 27, the Department of Health and Human Services (HHS) published the Federal Medical Assistance Percentages (FMAP) for the Medicaid program that will become effective October 1, 2010 and last until September 30, 2011 (fiscal year 2011). Medicaid provides health coverage to many low-income, vulnerable populations including children and youth in foster care. Medicaid is a federal-state partnership program and FMAP is the percentage that the federal government contributes. Medicaid FMAP rates also determine a state's matching rate for its Children's Health Insurance Program (CHIP) and Title IV-E programs. For FY 2011, FMAP rates range from 50% to nearly 78%. The list of FMAP rates for FY 2011 can be downloaded.

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SAMHSA Administrator Confirmed

On Friday, November 20, the U.S. Senate unanimously confirmed Pamela Hyde as Administrator of the Substance Abuse and Mental Health Services Administration. As administrator of SAMHSA, Hyde will oversee the Center for Mental Health Services, the Center for Substance Abuse Prevention, and the Center for Substance Abuse Treatment. Hyde has 30 years of experience managing and consulting health and human service public systems, including most recently serving as Secretary of the New Mexico Human Services Department. Hyde also brings a wealth of knowledge from having been Director of the Ohio Department of Mental Health, the Ohio Department of Human Services, and the Seattle Department of Housing and Human Services. She has also consulted for or been involved with the John D. and Catherine T. MacArthur Foundation, the American College of Mental Health Administration, and the President's New Freedom Commission on Mental Health.

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Combined Federal Campaign Ends December 15

The end of the year is rapidly approaching and the Combined Federal Campaign will end on December 15. During this annual campaign, federal employees can designate a nonprofit to receive donations. CWLA's CFC number is 11125. Please consider making a contribution. We depend on the generosity of friends and family to sustain the important work we do.

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Register for CWLA's 2010 National Conference!

The registration program for CWLA's national conference, Children 2010: Leading a New Era, is now available online. The program gives details about the conference, which this year features more than 120 child and family experts reporting on timely and important topics like adoption, foster care, technology, executive leadership, early childhood and mental health, juvenile justice, and residential services. The national conference is a month earlier this year--January 24-27, 2009--so it is important to register soon! Register now and receive early-bird rates, which end Friday, December 11.

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.

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Key Upcoming Dates for Congress

December 11: Hanukkah Begins
December 18: Second continuing resolution expires
December 18: Tentative adjournment for the House of Representatives
December 25: Christmas Day
January 24-27: CWLA National Conference
January 26: Projected date for State of the Union

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