Bill Passes House
Before House action came to a halt in response to a gun-control sit-down protest, the House of Representatives passed the Family First Prevention Services Act, (HR 5456) by a voice vote. The legislation was taken up on Tuesday, June 21 as part of the House suspension calendar which is a House method of moving bills more quickly. After approximately 25 minutes of commentary, mainly by House Democrats, it was passed on a simple voice vote. There was limited commentary by Republican supporters led by Congressman Vern Buchanan (R-FL), the bill sponsor who offered up positive comments. On the Democratic side the commentary was limited to Congressman Sander Levin (D-MI), Congressman Lloyd Doggett (D-TX) and Congressperson Karen Bass (D-CA).
The legislation, which has been endorsed by CWLA and by several groups will now move over to the Senate. A Senate version, S 3065, was introduced on Friday, June 17 by Senators Hatch (R-UT), Wyden (D-OR), Bennett (D-CO) and Grassley (R-IA). The House bill was listed on the Senate calendar. The process for moving the bill is still being discussed.
The commentary by Democrats largely reflected earlier statements by some committee Democrats for its lack of funding outside of child welfare services. Congressman Levin repeated the support that he offered in Committee the week before while most of the time was used by Congressman Lloyd Doggett (D-TX). Doggett repeated his concerns about the funding offsets and the lack of immediacy in implementing the upfront intervention services.
Representative Bass used her time to offer support but also raised concerns on the need to address some of the issues that bill is raising in the nation’s biggest state. California stakeholders, in the midst of a major reform that seeks to eliminate the use of group or congregate care, have expressed concerns around the mandates regarding nurse coverage (on site during business hours), some of the screening provisions that they feel do not align with their own best-practice designs and the new definitions that limit the use of Title IV-E funds for youth 16 or older aging out of foster care or transitioning from juvenile justice placements. Many of the concerns have been expressed by state, county and advocacy leaders.
The Budget Costs
Before the bill was adopted the Congressional Budget Office (CBO) score or cost calculation was released. The CBO score indicates that the cost of expansion is more than offset and actually results in $66 million in federal savings over the ten-year required budget scoring time-period. The cost is offset by the restrictions in residential/group care and the delay in the adoption assistance delink. The cost includes $1.3 billion in up-front services which start in FY 2020. The ten-year cost calculation is for the entire ten-year period but most of the federal costs is incurred between the 2020 to 2026-time period. Additional costs of the legislation are a continuation of the Court Improvement Program (CIP) at $20 million a year for five years, funding for evidence-based Kinship Navigator programs costing $3 million next year rising to the $15 to $17 million range by 2022 and a one-time grant of $8 million for grants to states to promote foster parent recruitment. Almost all savings are from the restrictions and new definitions of institutional care ($910 million) and the delay in the adoptions assistance de-link for children 3 through infancy ($720 million)
In regard to a criticism of the legislation expressed by Congressman Tom Price (R-GA) that although the legislation meets the “paid-for” over the next ten years but after the ten years it increases the deficit, CBO did weigh-in. CBO indicated that in the ten year periods beyond 2057 (i.e. between 2057-2067) it could increase the deficit by possibly more than $5 billion in the second half of the 21st century.
Hopes For New Intervention Funding
Many advocates see the legislation as offering a potentially wide expansion and access to Title IV-E entitlement funding for tested and approved mental health, substance use and in-home services 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. Services could also be available to a foster youth who is pregnant or parenting. Services would be limited to promising, supported and well-supported programs with an emphasis on well-supported. 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. Programs funded would have to meet promising, supported and well-supported programs as defined in the bill. 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 around promising, supported and well-supported.
A state would have to opt into such funding through an amendment to their five-year state plan outlining services provided, strategies and workforce standards. While 12 months may not be long enough for some program models, funding could provide a vital link or supplement to services that are already drawing on other state and federal dollars.
Many but not all of the concerns raised revolve around the new definitions the bill puts in place regarding institutional care. It amends current definitions of foster care within Title IV-E to include a definition for family foster care homes limited to homes of six or fewer children (with state ability to waive the definition for sibling placements, children with special relationships to the foster parent, and children with disabilities). In addition, it includes a new definition of child care institutions of 25 or less by creating a definition of qualified residential treatment program (QRTP). Current IV-E definitions simply define residential care as child care institutions of 25 or less. The legislation includes the requirements around screening, planning and oversight and of particular criticism is the provision that requires a licensed or registered nurse and clinical personal on site during business hours and available 24 hours 7 days a week. That provision has been criticized by some stakeholders.
Other criticisms have been leveled at a lack of extension of current child welfare waiver authority, requirements around state maintenance of effort (MOE) around currents state spending and the potential effect of IV-E limitations with some transitional living programs for youth 16 to 18.
Title IV-B Programs Reauthorization
The legislation also reauthorizes the two Title IV-B programs: Child Welfare Services (CWS) and Promoting Safe and Stable Families (PSSF). CWS is annually appropriated and is now down to $269 million a year. PSSF, which includes the CIP is set at $345 million in mandatory funds and $69 million in appropriated funds. The bill extends the two programs and makes some age changes to the Chaffee Independent Living Program. To extend the court funding requires Congress to find $20 million a year because CBO considers it “new” spending despite the fact it is a continuation of the same program. The IV-B changes are:
- Extension of the adoption-kinship incentive fund (part of IV-E)
- Extension of the Regional Partnership Grants of $20 million with adjustments including mandated participation by state substance abuse agencies and new funding allocations
- Continuation of the $20 million caseworker visit-workforce funds,
- Increased eligibility for the Chaffee Independent Living program to age 23 (IV-E),
- Increased eligibility for Chaffee student voucher eligibility to age 26 (IV-E)
- Elimination of the 15-month time-limit on the use of PSSF funds for reunification services,
- A set aside for a grant to spread the use of the NEICE Interstate Compact expansion initiative
- Requirements to include evidence of being in foster care as part of the document package for youth that age out (to assist young people eligible for Medicaid to age 26 if they were in foster care)
- Continues the Court funding (CIP)
- A new $8 million to create competitive grants that will address foster parent recruitment
The next steps are for this bill are unclear with a limited amount of time remaining before Congress leaves for the summer. The House bill is on the Senate calendar and it could be taken up and approved by the Senate under the Senate process called “unanimous consent” or “UC.” That would mean a voice vote but it also means any one senator could object and block the bill for any reason including the budget issues raised in the House. An alternate would be to take up the bill in the Senate Finance Committee but that option would likely be only to re-affirm support. Any changes in the bill would mean that the bill would have to go back to the House for at least voice vote approval—a House that quickly adjourned session last week to start the July 4th break earlier due to a confrontation over gun control. Any changes would likely also mean a new budget score and an increase in funding would mean new offsets from somewhere and child welfare is tapped out as far as a source of savings.
Both houses are taking abbreviated July 4th breaks. The House left last Thursday and will return on July 5th. The Senate will leave this Thursday or Friday and will return on July 6th. After that both houses intend to leave by July 15th until after Labor Day.