Capitol Child Advocate

Dear Child Advocate,

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March 17th, 2008

In this week's issue of the Capitol Child Advocate:

MISSOURI:

1. Budget Approved by House Committee

2. QRS Adopted by Senate

3. Child Care Affordability: A Look Ahead

4. Update on Insure Missouri

5. Newly Filed Children's Health Care Bills

KANSAS:

1. Early Care & Education Budget Update

2. Subcomittee Drafts Recs on Child Care Licensing

3. Committee Approves Expansion of HealthWave Eligibility

4. Graduated Driver's License Update

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MISSOURI LEGISLATIVE UPDATE

Missouri Lawmakers left the capitol on Thursday to head back to their districts for a week-long break marking the mid-point in the 2008 Legislative Session. With the budget expected to be debated in the House soon after lawmakers return on the 25th, and with several important children’s bills filed and moving slowly through the political process, NOW is a great time to contact your elected officials and let them know that Missouri’s children should be our highest priority!

Partnership for Children asks you to SAVE THE DATE for a statewide call in day on Wednesday, March 26th to urge state lawmakers to make children’s health and early education a budget priority this year. In a tough budget year, there are several children’s initiatives that are at risk of being cut – state legislators need to hear from their constituents that investments in our children produce great rewards for our state. Look out for more updates and opportunities to take action later this week!

Budget Approved by House Committee

Last week the House Budget Committee reviewed and marked-up the recently filed house budget bills. Overall, services and programs for children were left untouched by those seeking additional funding for other programs. Of particular interest to children’s advocates, Rep. Ryan Silvey (R-Kansas City), offered an amendment requesting $3.3 million dollars to improve access to the state children’s health insurance program by expanding presumptive eligibility to community health centers and rural health clinics. The amendment passed by a voice vote. This was a new decision item not previously included in the Department of Social Services Budget nor in the Governor’s recommendations.

HB 2011 did not recommend a general revenue increase for the child care subsidy program, but it does re-appropriate federal savings to partially fund the Governor’s proposal. The Governor had recommended $2.4 million dollars of new general revenue to offer transitional child care assistance to families between 127% - 150% of federal poverty. As the appropriation stands in HB 2011, parents would receive a transitional benefit up to 139% FPL, which will allow a parent to earn up to $1 more an hour without losing all of his or her child care subsidy benefits. Partnership for Children calls on the General Assembly to provide the Governor’s full budget request for the transitional benefit for child care assistance. Rep. Kiki Curls (D-Kansas City) offered an amendment to provide half of the Governor’s recommended $2.4 m for transitional child care assistance. Rep. Curls’ amendment to take $1.2 million from the MO HealthNet Case Management line item failed; therefore she was unable to offer her increasing amendment for the child care program. Funding for the transitional child care assistance program remains one of PFC’s top priorities.

The House is expected to take up and debate House Bills 1-13 after Spring Break. Partnership for Children will continue to work with the Senate Appropriations Committee to protect funding for presumptive eligibility and rate increases for foster parents and the adoption subsidy program. In addition, PFC and other advocates will continue to advocate for additional appropriations for the child care subsidy program. We will keep you posted as the bills move through the House and Senate Appropriations.

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QRS Adopted by Senate

SB726 (Shields), establishing a Quality Rating System for early childhood and afterschool programs, was initially adopted in the Senate last week after a debate lasting 5 hours with several controversial amendments. It is important to note that the bill was perfected on a voice vote, but must still be third read with a recorded vote count before it continues on to the House.

Two amendments that were narrowly defeated highlight a concern from many Senators and child advocates that low-income families will not be able to afford quality early childhood programs. Missouri will see the greatest economic benefits by simultaneously improving the quality and affordability of child care to ensure that our most at-risk children can access quality programs that improve outcomes in K-12 education.

Senator Justus (D-Kansas City) offered an amendment to raise eligibility for child care assistance to 140% of federal poverty and offer transitional assistance with reduced benefits up to 185% of FPL. This amendment sparked a discussion between Senators Nodler (R-Joplin) and Green (D-St. Louis County) regarding the legitimacy of requiring appropriations through statute in which Senator Nodler, who chairs the Senate Appropriations Committee, claimed that similar efforts such as legislating tax credits were ok because tax credits always have at least a $1-$1 cost benefit ratio. Numerous studies show that quality early childhood programs return economic benefits on average at $7 for every $1 invested, because parents are more productive and successful in the workforce and children are better prepared to succeed in kindergarten through graduation. The amendment was defeated by a tie vote (15-15).

An amendment offered by Senator Rupp (R-St. Charles) would have delayed implementation of the Quality Rating System until Missouri ranked in the 25th percentile among states for offering child care assistance. The amendment was defeated 16-14. A second amendment by Senator Rupp that passed on a voice vote will automatically give the highest rating to licensed child care programs that are accredited by the National Association for the Education of Young Children. This could be problematic in implementing the QRS since there are 6 other accrediting agencies that are recognized in Missouri in addition to NAEYC.

Finally, a $5 million amendment by Senator Smith (D-St. Louis) to create a pilot program within the Missouri Preschool Project that would provide quality pre-k programs to children in unaccredited school districts, passed with a surprising 21-7 vote. The original version of the bill (SB 779) included provisionally accredited school districts such as Kansas City Missouri School District but they were excluded from the amendment offered to SB 726 on the floor.

The Quality Rating System now has to be approved by the entire Senate and then heads to the House. Rep. Ward Franz has a companion bill in the House (HB1524) that has not been referred out of committee.

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Child Care Affordability: A Look Ahead

SB 776 (Justus) is on the Senate Calendar for Perfection, but since a similar amendment was offered to the SB 726, the Quality Rating System, and failed to pass it seems unlikely that SB 776 will be brought forward for debate. This bill raises income eligibility for child care assistance to 140% of federal poverty and extends transitional assistance to 185% of FPL. It also increases child care provider reimbursement rates up to the regional market rate.

The companion bill in the House, HB 2264 (Grisamore), has yet to be referred to a committee. HB 2264 establishes the intent of the General Assembly to raise eligibility for child care subsidy to 185% of federal poverty by 2012. It also phases in a provider rate increase to the market rate by 2012.

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Insure Missouri Update

Efforts to ensure that 54,000 low income working families have faced significant complications this year. After growing criticism towards the proposal and the way in which it was introduced Governor Blunt announced that the Department of Social Services was withdrawing the Emergency Rule to implement Insure Missouri in order to allow time to build legislative consensus in support of the program. While Phase 1 of Insure Missouri will not be implemented in March as planned, there is still a possibility that it can begin after July 1, 2008. Talks have continued among the members of the General Assembly, the Missouri Hospital Association, and the managed care plans, the Department of Social Services, and health advocates to reach consensus.

Most recently, Missouri Republicans have filed legislation to implement the governor’s proposed Insure Missouri plan and are intent that something will pass this year. Sen. Tom Dempsey (R-St. Charles) has filed legislation in the Senate to provide health coverage to an additional 150, 000 people, however, it is subject to appropriation. The bill would provide health care to people who make up to 225 percent of the federal poverty level. To be eligible, a person must be between 19 and 65 years old and not eligible for health insurance under their employer and must be uninsured for at least 6 months. The bill would also provide tax credits to small employers to use to provide insurance to their employees. In addition, participants would be required to contribute a percentage of their income — anywhere from 1 to 5 percent — to a health savings account used to purchase their own private insurance. HB2398, introduced by Rep. Rob Schaaf (R-St. Joseph) and HB2413, introduced by Rep. Doug Ervin R-Kearney have also filed bills in the House implementing an Insure Missouri Program.

None of the proposals addresses the barriers to coverage for children including premiums or the affordability standards. However, research has shown that when parents are covered by insurance their children are more likely to see a doctor for well-child check-ups, get the medicines they need and are less likely to use costly forms of health care like the emergency room. PFC supports efforts to cover our most vulnerable which would include the elderly and disabled.

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Newly Filed Children’s Health Care Bills

Nurse Home Visiting: Rep. Jason Holsman, (D-Kansas City), has filed two pieces of legislation that seek to positively impact children’s health outcomes. HB 2423 proposes to allow home visits by registered nurses for at-risk newborns to be covered by MO HealthNet. The Kansas City Health Department currently has funding from the Department of Health and Seniors Services and some private funding to provide nurse home visiting through the Building Blocks program. This program is an evidence-based, nurse home visitation program that improves the health, well-being and self-sufficiency of low-income, first-time parents and their children. Nurse home visitors seek to achieve three main goals with their patients:

Improve pregnancy outcomes by helping women engage in good preventive health practices, including obtaining thorough prenatal care from their healthcare providers, improving their diet, and reducing their use of cigarettes, alcohol and illegal substances;
Improve child health and development by helping parents provide responsible and competent care; and
Improve the economic self-sufficiency of the family by helping parents develop a vision for their own future, plan future pregnancies, continue their education and find work.

Throughout the county, the most common sources of funding for nurse home visitation programs are state and county government general funds, Medicaid, MCH Title V Block Grants, Temporary Assistance for Needy Families (TANF), Tobacco Settlement Funds, locally obtained grants and charitable foundations.

Expanding Health Care for Children: Rep. Jason Holsman (D-Kansas City, also introduced HB2424, which expands the state children’s health insurance program to all children regardless of income. Children in families with incomes over 300% of federal poverty level could participate by allowing families to buy-into the program at the premium rate paid by the state.

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KANSAS LEGISLATIVE UPDATE

Thanks to our partners at Kansas Action for Children for providing this update.

Early Care & Education Budget Update

Child Care Assistance: The Senate SRS Budget subcommittee concluded deliberations March 10 on the SRS budget. Most requests in the budget for new spending were deferred until Omnibus, including $2.5 million for the Child Care Assistance program. The full Ways and Means Committee will take up the SRS budget report on Thursday, March 20. It is possible that funding for the Child Care Assistance program will be added by the full committee or during House-Senate budget negotiations.

Early Childhood Block Grant: The Early Childhood Block Grant proposed in the SRS budget was also deferred until Omnibus. The block grant would be administered by the Children's Cabinet and be funded by monies from the Children's Initiative Fund (CIF). There were several attempts in the subcommittee to divert CIF monies to fund other programs. However, Sen. Vicki Schmidt (R-Topeka) was successful in preserving CIF funds for early childhood programs and the proposed block grant.

Parents as Teachers: The House Appropriations Committee approved the education budget on March 11. Although not included in the Governor's Budget, the Committee will consider adding $2.6 million in Omnibus to address the Parents As Teachers program's waiting list, which includes more than 4,500 Kansas families. The Senate has recommended adding $1 million to the PAT program in Omnibus.

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Subcommittee Drafts Recommendations on Child Care Licensing

The House Federal and State Affairs Subcommittee on Child Care voted March 10 to untable four child care bills. The subcommittee loosely drafted recommendations - taken from each of the bills - to be brought to the full committee for discussion. Two of the four bills in the subcommittee never received hearings. It is unclear if there is enough time in the Session for the Committee to hold hearings and take action on the recommendations. The Committee's agenda for next week has not yet been finalized.

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Committee Approves Expansion of HealthWave Eligibility

Under new language included in SB 541, the fastest-growing group of uninsured children in Kansas will have access to the HealthWave program beginning in 2009. The Senate Health Care Strategies Committee approved an expansion of the HealthWave program to 250 percent of the poverty level during their March 10 meeting. The proposed legislation would extend HealthWave eligibility to 225 percent of poverty beginning July 1, 2009, and would extend eligibility to 250 percent of poverty the following year. The full Senate is expected to debate and vote on the bill next week. TAKE ACTION TODAY! Tell your Senator that you support extending the HealthWave eligibility because it is a cost-effective approach to providing more Kansas children with access to health care. Click here to find and e-mail your Senator.

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Graduated Driver's License Update

The House Transportation subcommittee reported back to the full committee March 10 with its recommended changes to SB 294. Although the subcommittee's recommendations do not address the three primary policy changes included in SB 294, it is still important for the full committee to vote on the bill and send it to the House floor. TAKE ACTION TODAY! Let your Representative know you support a comprehensive Graduated Driver's Licensing system and that you want the House to pass SB 294 this year. Click here to find your Representative.

Until Next Week –

Carrie & Emily

Policy & Outreach Coordinators