Statement by Christine James-Brown, President and CEO, Child Welfare League of America (CWLA) Re: Moratorium on Medicaid Regulations
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June 27, 2008, Arlington, VA -- CWLA is pleased that Presidential candidates Hillary Clinton and Barack Obama have joined on as cosponsors of Senate bill S.2771, legislation to re-establish a White House Conference on Children and Youth. While both Senators Clinton and Obama have been competing in a grueling and competitive Presidential campaign, we are grateful that they were able to come together in support of a White House Conference on Children and Youth.
CWLA is grateful that Congress has taken the authority and opportunity to delay the Medicaid Rehabilitative Services and Targeted Case Management (TCM) rules, as well as four other controversial rules by including a moratorium on them in the war supplemental appropriations bill. By doing so, Congress has a made a loud and clear statement that it is wrong to target the most vulnerable segments of American society. History will judge us by how well we treat our children, particularly in these uncertain economic times
CWLA believes that every child deserves a safe, loving, and stable environment, as well as coordinated, continuous, comprehensive, and culturally competent health care services. Children and youth who have been removed from their home and placed in out-of-home care experience a disproportionate amount of physical and mental health needs due to factors completely beyond their control, such as maltreatment they were exposed to in the home, and the life-altering consequences of breaking familial ties. Medicaid, offering physical and mental health services to some of our most disadvantaged, rightly steps in to provide care for children in foster care and is critical to getting these youngsters on a path to recovery.
The current Administration, however, has long been attempting to restructure Medicaid, often times with proposals that would likely limit access to much utilized and much needed services. . Two of these rules in particular-one on Medicaid Rehabilitative Services and one on Targeted Case Management (TCM) Services would have been particularly devastating to children in foster care. Rehabilitative Services help reduce physical and mental disabilities that many children in care experience as a result of abuse, neglect, or similar trauma all the while keeping the children in loving community-based settings. Taking into account the vulnerability and complex needs of children-including health needs, at least thirty-eight states use TCM to ensure that children in foster care receive a comprehensive approach and greater coordination of care.
The Rehab and TCM rules as written by the Administration, amongst several other troubling provisions appeared to wholly shift costs to the already struggling child welfare and foster care systems. If these systems were able to shoulder the financial burden alone-which is questionable-the timeliness of intervention and the quality of services may have been jeopardized. The rules also largely obliterate the goal and need for systems to work together towards the well-being of children in care.
CWLA is extremely thankful to Congress for delaying these restrictive regulations. We are also grateful to our colleagues from the mental health, community mental health, and disability communities who partnered with us in this endeavor. CWLA is ready in the upcoming months to work with Congress, the Administration, and stakeholders to find logical solutions to protect these vital streams of care and even more generally, preserve and strengthen the Medicaid program's essential role in health care delivery.
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