During the summer break Senator Orrin Hatch (R-UT) and Senator Ron Wyden (D-OR) and their offices reached out through a conference calls to supporters and other stakeholders encouraging them to promote the bill while Congress was out of session.
Also holding webinars along with power point presentations were a coalition of California groups including state, local and Burton Foundation officials, New York State officials, Casey Family Programs, American Public Human Services Association (APHSA), the National Foster Youth Institute and Foster Club. The National Association of Counties (NACo) also held their conference during the summer break where the legislation came up for discussion.
Much of the opposition, by states especially, is related to the cost shift within the legislation. Both California and New York State have highlighted the loss of federal funding much of it do to the restrictions on IV-E funding for group home/congregate care placements that would begin in three years. California has also highlighted several concerns of how the new bill will not align with some of their recent reforms including requirements around court oversight, the requirements involving staffing of residential facilities, (nursing staff), the screening requirements for children in care and complications over federal foster care funding for children who might lose IV-E eligibility due to current law definitions of the child’s “home of removal.”
Other states, as well as California have also criticized the requirements around the “maintenance -of-effort” (MOE). MOE’s are spending provisions found in many federal laws (i.e. TANF, child care, Title I education, IDEA, the substance abuse and mental health block grants) which seek to assure that increased federal funding won’t result in state funding cut backs due to increased federal funding support.
The New York state conference call also emphasized concerns over potential funding cuts coming largely from the restrictions on congregate/group homes that would start in FY 2020. In that call the state officials bundled the potential cuts here with the new requirements imposed through the recent reauthorization of the Child Care and Development Block Grant (CCDBG) which is causing some states to seek waivers of the new child care provisions due to a lack of federal funding increases (see Child Care Advocates Seek Funding Increases).
Proponents, including CWLA have endorsed the legislation (description of legislation here) because on balance we believe that over the long term, the expansion of entitlement funding through Title IV-E for mental health and drug treatment and some limited in-home services offers a potential historic funding source for two behavioral health needs that have not been addressed by many state Medicaid programs over the fifty year history of that program.
In addition to extending access to Title IV-E entitlement funding for approved mental health, substance use and in-home services, such eligibility is not tied to the outdated link to the 1996 AFDC program. Instead of an income-based eligibility there would be an eligibility based on whether or not the child is at-risk of a foster care placement and considered a “candidate for foster care.”
For these candidates, the child, the parent, guardian or adoptive family would be eligible for services for up to 12 months in a spell but not limited in a lifetime. Services would also be available to a foster youth who is pregnant or parenting. Eligible services would be limited to promising, supported and well-supported programs with the bulk of funding directed toward well-supported-HHS-approved services.
There would not be a limit on the number of 12 month spells in a child or family’s lifetime. These funds could also flow to post-permanence placements including children who are reunified and adoptive families who latter are in need of counseling and other interventions.
These new provisions as well as the restrictions regarding institutional care would start in FY 2020 which starts on October 1, 2019. Because programs would have to meet promising, supported and well-supported programs, by October 1, 2018 HHS would issue guidance on the practices criteria required for services or programs to satisfy the law’s requirements. HHS would also provide a pre-approved list of services and programs that meet the requirements.
