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

   
   
Vol. 23, Issue 7: 3/1/2010   
Headlines

March Forth for Child Care & Head Start: Action Alert

HHS Replaces 2008 Guidance on Kinship/Guardianship Care

Sebelius Awards $100 Million to 10 States

Second Jobs Bill May Include Medicaid Relief

Raising Dental Health Awareness

Key Upcoming Dates for Congress



March Forth for Child Care & Head Start: Action Alert

On Thursday, March 4 the National Women's Law Center, with CWLA and many other organizations, plans to "march forth" and secure the President's proposal for increased funding for child care and early education. You can use a toll-free number (888-460-0813) on that day to call your members of Congress. As the annual budget process proceeds, child care advocates are working to make sure senators and representatives know that increasing child care funding along the lines that the President has requested is necessary. While the President set an important tone, Congress must also hear from their constituents if the investments in the Child Care and Development Block Grant, Head Start/Early Head Start, and child nutrition through the Child and Adult Care Food Program are to become a reality. The budget proposes $1.6 billion in increased child care funding and nearly $1 billion more for Early Head Start and Head Start. Although there are several changes the President is asking for, the message to Congress is relatively simple. To assist callers, the Law Center has prepared talking points, facts, and suggested letters for constituents.

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HHS Replaces 2008 Guidance on Kinship/Guardianship Care

In a press released last week, CWLA President and CEO Christine James-Brown praised the Administration for issuing new guidance on how states can implement the new Title IV-E kinship Guardianship program. James-Brown said, "The Administration's leadership and action will help potentially thousands more children and their relative caregivers." In a new program instruction (ACYF-CB-PI-10-01) dated Thursday, February 18, the Department of Health and Human Services, through the Administration on Children and Families (ACF) pulled back guidance that had been issued on December 24, 2008 that was seen by some states and advocates as limiting Title IV-E Kinship care coverage under the Fostering Connection Act (P.L. 110-351).

The new instruction states that this "allows Title IV-E agencies to convert legal guardianships that existed prior to the plan submission, including those that may have been supported through state or tribal funds." Under the 2008 directive, HHS was basically saying that only new kinship arrangements agreed to once a state had implemented the kinship option could be covered. But under this instruction, it is possible that some children and kin families now enrolled in state-funded programs could be covered as long as they meet all the requirements once they went into the original placement. In the President's new budget, the Administration projects more than 14,000 children are expected to be covered under the new law in fiscal year 2011, an increase from 5,000 in the current year. This new instruction could increase that number if the result is that more states act on taking the Title IV-E kinship option. States will still have to make sure the caregiver, child and the state meet all the requirements and the new instruction also indicates that if a state plans to make claims for children in kinship care prior to the plan amendment creating a Title IV-E kinship program, the "agency must submit a description to ACF that explains the process it will use to ensure that claims will be submitted on behalf of only those children that meet the eligibility requirements." Download the full Program Instruction.

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Sebelius Awards $100 Million to 10 States

Health and Human Services Secretary Kathleen Sebelius announced $100 million in federal grant funds to 10 states to improve health care quality and delivery systems for children enrolled in Medicaid and the Children's Health Insurance Program (CHIP) last week.

The grants, which will be awarded over a five-year period, were federally funded by the CHIP Reauthorization Act of 2009. The grants will assist states with implementing and evaluating provider performance measures in order to improve the quality of care delivered to children. Eight of the 10 grantees will test a new set of child health quality measures, and 7 of the 10 states will use the funds to implement health information technology strategies with two states specifically planning to develop a new pediatric electronic health record format.

Awardees represent both single-state projects and multistate collaborations. Grantees working in multistate partnerships will share award funds, so the funds will actually be distributed among 18 states. The awards were granted to Maine, Vermont, Oregon, Alaska, West Virginia, Pennsylvania, North Carolina, Florida, Illinois, Massachusetts, Colorado, New Mexico, Utah, Idaho, South Carolina, Maryland, Georgia, and Wyoming.


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Second Jobs Bill May Include Medicaid Relief

After the Senate passed its jobs bill (H.R. 2847) with more than 70 votes, leadership began discussions on a second bill that would pick up additional parts of a Senate package that had been pulled by Senate Majority Leader Harry Reid (D-NV). The goal is to break the jobs legislation in parts so that it can overcome filibuster hurdles in the Senate. The Democrats have indicated that a second bill will likely include the extension of the increased Medicaid match for an additional six months. The 6.2% increase in the Medicaid match rate is due to expire at the end of this calendar year. The proposal would extend it through the end of June 2011. The increased match also extends to state Title IV-E foster care, kinship care, and adoption assistance funding.

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Raising Dental Health Awareness

Research has shown that children in care tend to have a higher prevalence of chronic medical, dental, mental health, developmental, and educational needs than other children. To the extent that children even have a routine system of care, once placed in care we know that there are often a host of barriers that these children and their foster parents face inherent barriers resulting in sporadic and crisis care, instead of preventive care. Poor dental health can have lasting affects on a child's ability to learn, child development, and overall health.

February was National Children's Dental Health Month and to conclude a month of efforts to raise dental health awareness, last week The Pew Center on the States released The Cost of Delay: State Dental Policies Fail One in Five Children. The report found that approximately one in five children go without dental care each year, and while states play a key role in ensuring that low-income children have access to basic, preventive dental care, only a third of states are doing so. The report also found that 80% of childhood dental disease is concentrated in 25% of children, with the burden falling heavily on low-income and minority families, who often face barriers in terms of accessing care. Although states are required to provide dental care to Medicaid-enrolled low-income children, only one in three children actually receive services.

Some states are making great strides in terms of addressing the dental health of children, and others can continue the progress by addressing the lack of dental care for children, including focusing on prevention, investing in public health programs, improving the state Medicaid programs, implementing innovations with the workforce.

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Key Upcoming Dates for Congress

March 28-April 11: Spring break for Congress
April 15: Deadline to adopt budget resolution
May 15: House may begin passing regular appropriations bills
July 3: Target date for House to pass all 12 appropriations bills
August 7: Target date for senate to pass all 12 appropriations bills


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