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

   
   
Vol. 18, Issue 37: 9/26/2005   
Headlines

Senator Gordon Smith Addresses CWLA Advisory Board, Urges Continued Opposition to Medicaid Cuts

Reconciliation Bill Could Impose Bigger Cuts On Human Service Programs

Disaster Relief Bills Continue to Move

Medicaid Gains Praise, Possible Reforms Slated to Continue

House Approves Head Start Reauthorization

Rangle Asks for Study of Disproportionality in Child Welfare

House Passes Children's Safety Act, Eliminates Opt Out on Foster Care Checks

State Adoption Incentive Funds Released

Key Upcoming Dates for Congress



Senator Gordon Smith Addresses CWLA Advisory Board, Urges Continued Opposition to Medicaid Cuts

On September 22, Senator Gordon Smith (R-OR) addressed the CWLA Mental Health Advisory Board and many other child advocates listening in through teleconference. Smith urged his colleagues in Congress to indefinitely delay cuts in Medicaid through budget reconciliation. He agree there is a clear need for reform in Medicaid and expressed confidence this will come in the months ahead, but said it should not be done in the context of cutting the federal budget.

Smith is the leading advocate in the U.S. Senate to maintain and preserve entitlement programs, including child welfare. He and Senator Olympia Snowe (R-ME) are the principal Republicans on the Senate Finance Committee opposed to recent proposals to severely limit and cut child welfare services provided through Medicaid. In his remarks, Smith proved to be a strong, eloquent advocate for vulnerable children and families who rely on Medicaid and other human service programs.

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Reconciliation Bill Could Impose Bigger Cuts On Human Service Programs

Several members of Congress last week were pressing for cuts in government spending as a way to offset the cost of disaster relief. Echoing the sentiment of some other members of Congress, House Majority Leader Tom DeLay (R-TX) said on September 20 of the $35 billion in program cuts required under the budget reconciliation process, "That is a floor; that is not a ceiling." In other words, the reconciliation, although delayed until late October, could actually be used to cut programs by more than the amount allowed in the budget resolution adopted last spring. Despite going above the required $35 billion in cuts, the legislation would still be protected by the "fast-track" protections a reconciliation has, meaning that time of debate and amendments offered would be strictly limited. Senate Majority Leader Bill First's office indicated that the use of the reconciliation in this way was one of many options being considered.

Other members offered suggestions for cutting spending that could be added to or moved separately from reconciliation. On Wednesday, the Republican Study Committee released a report, RSC Budget Options 2005, authored by a caucus of conservative House Republicans, that included cuts of more than $100 billion next year and nearly $1 trillion over 10 years. Included were proposals to cap Medicaid administration, block grant Medicaid Acute Services, eliminate teen funding under Title X Family Planning, reducing the Earned Income Tax credit by $85 billion over 10 years, and reducing or eliminating funding for dozens of other domestic programs.

On the other side of the Capitol, Senator Jeff Session (R-AL) indicated on Tuesday that he favored across-the-board cuts of 1% or 2%. Under this scenario, all programs, including Child Care, Promoting Safe and Stable Families (PSSF), the Child Abuse Prevention and Treatment Act, Head Start, and many others would be reduced. Programs such as PSSF and Child Care have not experienced an increase in the past two years, and such a cut would increase pressure on these programs at the local level. It would also have the effect of providing increased funding for programs such as Child Care (see the following article) in the disaster-affected states while cutting funding across the nation. Other proposals for cuts include delay of the Medicare prescription drug program and cuts to the recently enacted transportation bill.

While the debate over budget cuts grows, there is increased talk of a continuing resolution (CR) to cover appropriations for the start of fiscal year 2006, which begins October 1. Whether the CR would run until Thanksgiving, when some members hope to leave, or whether it may even run into early 2006 is unclear. In all likelihood, a CR would fund programs at last year's appropriation level. At least 10 appropriations bills still need final approval (the Senate has 12 appropriations bills, and the House has 11).

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Disaster Relief Bills Continue to Move

Congress has continued to work on legislation targeting additional funds for Hurricane Katrina states and states affected by the movement of families from these states. Senate Health, Education, Labor, and Pensions (HELP) Committee Chair Mike Enzi (R-WY) introduced S. 1715, with the cosponsorship of Senator Edward Kennedy (D-MA). The bill focuses on education and child care-- in addition to increased funding for K-12 and Higher Education, it would provide an additional $112 million for child care and $45 million for Head Start as it relates to the hurricane. This is an authorization of funding, which means it would still require an appropriation. The bill would also waive temporary income limits, work requirements, and copays for child care, as well as income and documentation requirements for Head Start, for children affected by Hurricane Katrina.

The HELP Committee is also expected to have at least one other bill focusing on health and mental health issues. At the same time, legislation in the Senate Finance Committee that would address child welfare issues and some other areas under committee jurisdiction may follow the Medicaid bill introduced by Senators Charles Grassley (R-IA) and Max Baucus (D-MT). The House is also working on a series of bills. On September 15, the Senate approved H.R. 3672 which would extends the TANF block grant until the end of December. The bill also provides some additional funding to the three states hit by Hurricane Katrina.

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Medicaid Gains Praise, Possible Reforms Slated to Continue

Center for Medicare and Medicaid Services (CMS) Administrator Mark McClellan reviewed Medicaid's response to victims of Hurricane Katrina in a Capitol Hill meeting with advocates last week. McClellan noted the role Medicaid is playing with evacuees and praised state efforts to remove unnecessary hurdles that would prevent individuals from receiving care. The current goal is to "make sure that evacuees get the services they need and that states receive adequate payment." CMS issued an executive memo September 2 that allows for greater flexibility in guidelines for individuals to qualify for Medicaid and the State Children's Health Insurance Program.

Texas, receiving more than 250,000 evacuees, has already received a Medicaid waiver to allow that state to alter services and other guidelines temporarily to ensure all evacuees receive the necessary health care. The model waiver template includes a special temporary category of Medicaid eligibility to provide services for those who normally would not meet income criteria; an emphasis on community-based placement for the elderly and persons with disabilities and other special needs to prevent institutionalization; and steps to ensure that payments are made to service providers. McClellan noted that other states affected bt Katrina are expected to receive waiver status shortly.

Despite increased demands on Medicaid caused by the hurricane, McClellan said this is an ideal time to revamp the 40-year program, as the Medicaid law "was written for another era." These reforms include part of Congress's budget reconciliation package, which is expected to cut $10 billion from Medicaid. Originally passed as a measure to curtail government spending, the budget reconciliation package, slated to cut $35 billion of entitlement spending, has come under increased scrutiny, and many lawmakers are pushing to have the proposed Medicaid cuts cancelled, if not the entire reconciliation package.

Even with the waiver for hurricane relief, Senate Finance Chair Charles Grassley (R-IA) and Ranking Member Max Baucus (D-MT) have introduced the Emergency Health Care Relief Act, (S. 1716), which would provide a 100% FMAP rate for Alabama, Louisiana, and Mississippi; additionally states providing services to hurricane survivors would receive a 100% match for services to those individuals. The two Finance Committee leaders had hoped to move the bill by week's end, but the White House continues to oppose its passage. There is no companion House bill.

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House Approves Head Start Reauthorization

On September 22, the House of Representatives approved H.R. 2123, legislation to reauthorize the Head Start program through 2011. The final vote followed closely along party lines, as Democrats objected to the addition of an amendment that allows religious-based organizations an exemption from civil rights provisions with regard to hiring practices. H.R. 2123 was approved by the House Committee on Education and the Workforce in May with bipartisan support and an understanding that members would continue to work on issues still outstanding. The House bill rejects the Administration's Head Start block grant from two years ago. Funded at more than $6.8 billion, the 40-year-old program was last authorized in 1998.

CWLA signed on to a letter that offered qualified support for the bill as it went to the House floor but also raised a number of ongoing concerns, some of which were addressed during the House debate. Areas of concern going to the House floor included provisions on teacher credentials that would increase requirements for Head Start teachers, but without the authorization of funding to carry out the new mandates. A second concern was over language on recompetition for current Head Start programs. Current language in H.R. 2123 could have the unintended effect of forcing most programs to undergo recompetition regardless of the quality of the program.

Of the issues that received floor debate, one dealt with local parent councils. Critics argued that the committee-passed legislation weakened the role of parent policy councils, and that has raised concerns over the effect this could have on local programs. Representative Mark Souder (R-IN) offered an amendment to restore the power of these councils, but it was defeated with more than 270 "no" votes.

A second amendment addressed ongoing concerns over the Administration's use of the National Reporting System (NRS)--a pre- and post-test for Head Start children. A May 2005 General Accountability Office (GAO) report confirmed some fears of critics, finding the NRS to be invalid and unreliable. GAO indicated the NRS is not an appropriate evaluation vehicle for children who are English language learners, especially those who speak neither English nor Spanish. Head Start advocates want the NRS suspended until the National Academy of Sciences (NAS) can make the test scientifically valid. (See Children's Monitor, May 23, 2005, for a more detailed description of the GAO report.) Representative Ron Kind (D-WI) offered an amendment to suspend testing while NAS conducts a review and provides guidance on appropriate child outcomes and assessments for young children. The amendment had the support of the Committee Chair John Boehner (R-OH) and was adopted by a voice vote.

The most controversial point of the Head Start debate was over an issue that had not been addressed in the Committee-passed bill. Representative Charles Boustany (R-WV) offered an amendment referred to as "charitable choice," to allow religious groups operating Head Start programs to hire on the basis of religious affiliations. Opponents criticized the amendment as allowing legal discrimination with the use of federal funds. Proponents claimed the amendment would provide needed flexibility to Head Start programs run by faith-based organizations. The amendment was adopted by a close party-line vote.

The Senate HELP committee passed S. 1107 for Head Start reauthorization on May 25. This version does not include the state pilot projects or the faith-based option pushed for by the Administration. The Senate may take up its bill in October.

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Rangle Asks for Study of Disproportionality in Child Welfare

Earlier this month, Representative Charles Rangle (D-NY), Ranking Member of the House Ways and Means Committee, sent a request to the Government Accountability Office (GAO) asking for an analysis of the overrepresentation of African Americans in foster care. This overrepresentation of minority children in the child welfare system is described as disproportionality and refers to a higher presence of certain racial or ethnic groups compared with the overall population.

While Rangle was requesting the GAO study, he also released a report from the Congressional Research Service (CRS) outlining the problem and giving an overview and some of the possible reasons offered to explain the disproportion of minorities in the foster care system. The CRS memo indicated that in 2003, 47% of children entering foster care were white, compared with 61% of the child population under 18, based on 2000 census figures. African American children accounted for 27% of children entering foster care, whereas their representation in the overall child population was 14%. Hispanic children were 18% of the overall census population but represented 17% of children entering care. American Indian and Alaskan native populations were also overrepresented, with 1% of the census population but 2% of children in care. Asian children stood at 3% of the child population under 18 but 1% of foster care entries in 2003.

The CRS document is on CWLA's website.

Rangle asked GAO to both investigate the reasons behind such overrepresentation and suggest potential remedies. Rangle said, "All children, regardless of race or background, want the same thing--a safe, loving and permanent home. Right now, reaching that basic goal seems particularly difficult for African American children in the foster care system." Once a request is made, a GAO report generally takes several months of investigation before its release.

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House Passes Children's Safety Act, Eliminates Opt Out on Foster Care Checks

On September 14, the Children's Safety Act (H.R. 3132) passed the House by a vote of 371-52. Introduced by Representative James Sensenbrenner Jr. (R-WI) the legislation aims to prevent "vicious attacks by violent sexual predators." The legislation requires establishment of a sexual offender registry to collect from offenders and makes available to the public specific information, such as names, Social Security numbers, addresses of residence and employment, educational establishments attending, license plate numbers and vehicle descriptions, photographs, fingerprints, and DNA samples. Depending on the severity of the offense, an offender would remain in the registry for 20 years to life. The bill includes strict requirements to keep the information updated and current.

Juvenile offenders would be treated as adults and would have to follow the bill's national registration and notification requirements. The scope of the bill is such that young adolescents adjudicated as delinquent for nonviolent sexual contact with playmates would face lifetime registration and notification requirements that would stigmatize and hinder their successful reentry into society.

The Children's Safety Act does not account for legal and social precedents that differentiate between children and adult offenders. The bill ignores the role adolescent behavioral, emotional, or developmental problems (or prior sexual abuse experienced by that child) can often play in sexually inappropriate behavior.

The bill also includes a provision to eliminate a state's ability to opt out of the required background check of perspective foster parents. Current law requires background checks in the foster care system, but allows states to implement their own standards. The bill sets a date of October 1, 2007, to implement the new requirement. California and New York, which have their own background check requirements, would be most effected by this change.

The Children's Safety Act is awaiting review by the Senate Judiciary Committee. The full text of this legislation in online.

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State Adoption Incentive Funds Released

On September 20, the Administration for Children and Families (ACF), U.S. Department of Health and Human Services, announced it would release $14.5 million dollars in Adoption Incentive funds to 24 states, the District of Columbia, and Puerto Rico. The fund was created by the Adoption and Safe Families Act of 1997 and reauthorized by the Adoption Promotion Act of 2003. The incentive payment plan is based on a state's ability to increase the number of adoptions. Each year, 51,000 foster children are adopted from the child welfare system.

Incentive bonus payments are based on a state’s baseline year--the year in which the state had the best rate of foster child placements. ACF awards a state $4,000 for every foster child placed above its previous annual best. Stats also receive dditional bonuses for older foster children, defined as children older than age 9, and for the adoption of children with special needs.

The awards were for federal fiscal year 2005. Florida received the most of any state, with an award of $3.4 million dollars. New York, Kentucky, and the District of Columbia were the only other jurisdictions to receive more than $1 million. New Jersey received the largest adoption incentive bonus for FY 2004. For a complete list of states and awards, go to www.acf.hhs.gov/news/press/2005/adoption_incentives.htm.

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Key Upcoming Dates for Congress

October 1: Start of Federal Fiscal Year

October 10: Columbus Day Break

October 19 (Approximate): Deadline for assigned committees to adopt $35 billion in cuts to mandatory programs for budget reconciliation bill

October 26 (Approximate): Deadline for tax-writing committees to adopt tax cuts of $70 billion

November-December Holidays: Target adjournment date


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