Capitol Child Advocate

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May 5th, 2008

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

MISSOURI:

1. Budget Victory for Children’s Health Coverage

2. Hearing on QRS this Wednesday

3. Urgent Update – TABOR (HJR70) Hearing in Senate

4. Insure Missouri Update

5. Forums Scheduled to Discuss Missouri's Child Care Regulations

KANSAS:

1. Children's Initiatives Protected in Proposed Budgets

2. Legislature Approves Health Reform Plan that Puts Children First

NATIONAL:

1. Bill Introduced to Address Boot Camps

2. Child Abuse Registry Being Studied

MISSOURI LEGISLATIVE UPDATE

BUDGET VICTORY FOR CHILDREN’S HEALTH COVERAGE

Last week the Senate and House continued to negotiate budget items that differed between the two chambers. Partnership for Children was tracking several items related to children’s services and programs, however, our main priority remained ensuring the conference committee funded presumptive eligibility at the House position. Last week, the conference committee closed on this line item at the total House appropriation of $11.8 million dollars (total with federal match)!!! This is a huge victory for children’s advocates as we have been pushing two years for the state to enhance their outreach and enrollment efforts. PFC would again like to thank our partners in this effort, Citizens for Missouri’s Children, the Missouri Association of Rural Health Clinics, and the Missouri Primary Care Association.

Presumptive eligibility is an outreach strategy that aims to reach kids and enroll them in the program in health care settings they are most likely to be seen for primary and preventive care – rural health clinics and community health centers. In total, there are approximately 400 of these clinics across the state. Over the last 2 ½ years, over 70,000 children have lost health coverage due to administrative and procedural changes, in additional to eligibility limitations placed on parents.

Here are the final budget recommendations on items that were also left open for debate last week between the two chambers:

Foster Care Rate Increase: House recommended a 4% increase ($1.3m total); Senate Recommended 2% increase ($0.6 total). The Conference Committee compromised on a 3% increase.

Adoption Subsidy/Guardianship Rate Increase: House recommended 2% increase ($1.2m total); Senate recommended 3% increase ($1.7m total). The Conference Committee compromised on a 3% increase.

Residential Treatment Rate Increase: House recommended a 6.64% increase or $5/day ($2.8m total); Senate recommended a 2% increase ($1.3m total). The Conference Committee compromised on a 2% increase.

Insure Missouri: House recommended $0; Senate recommended $395.1m total however, a bill must pass in order for the program to be funded. The Conference Committee chose not to fund Insure Missouri

Youth Smoking Prevention: House recommended $2m; Senate recommended $0. The Conference Committee compromised on $1.5 million dollars.

The budget must be completed by 6 pm on May 9^th.

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URGENT UPDATE – TABOR IN SENATE COMMITTEE

HJR 70, legislation that proposes a constitutional amendment that would create a spending formula for Missouri appropriations, had an unexpected hearing last week in the Senate Committee on Governmental Accountability and Fiscal Oversight. The Senate posted the hearing for the bill, scheduled for 8:30 am at 9 pm the night before. Rules dictate that hearings be posted at least 24 hours in advance. In addition, there was little time for both the proponents and the opponents to provide testimony, giving only enough time for the proponents. As a result, the Senate scheduled an additional hearing in order to give the opponents fair time to present their case. HJR70 puts a lid on spending. The amount of allowed growth in spending is linked to inflation and population growth. This bill would limit Missouri’s ability to determine appropriate funding levels for all programs and services putting those that serve children and families at risk. Partnership for Children strongly opposes this bill. The bill will be heard again, Tuesday, May 6^th at 9 am in the Senate Lounge.

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HEARING ON QRS THIS WEDNESDAY

After passing the Senate over a month ago, SB 726, establishing a Quality Rating System for child care programs, was finally referred to the House Special Committee on Family Services last Thursday. The bill, sponsored by Senator Shields (R-St. Joseph), will be heard in the House committee this Wednesday, May 7th at 8am.

SB 726 creates a 5-star rating system for early childhood and afterschool programs based on quality components like staff education, annual trainings, learning environment, and family involvement. The Quality Rating System will not only give parents a legitimate tool for evaluating and selecting child care for their children, but will also help providers improve the quality of their care by offering technical assistance and grants through a QRS Program Improvement Grant Fund.

Decades of research show that quality early childhood programs, especially for at-risk children, can dramatically improve educational and social outcomes later in life. Scientific research tells us that 90% of a child’s brain develops before the age of 5, making this a critical time for establishing a solid foundation for future success.

Improving the quality of child care in Missouri is an economic investment in the potential of our youngest citizens, but we must also ensure that our most at-risk children can afford the cost of quality early childhood education. Missouri lags behind nearly all of our neighboring states when it comes to investments in pre-k and child care assistance for working families. Improving the quality and affordability of child care will pay back returns on average of $7 for every $1 invested because children will be less likely to need special or remedial education, to drop out of school, or to enter the juvenile justice system.

Partnership for Children urges State Representatives to support SB 726 as well as efforts to improve child care affordability by expanding eligibility for our state child care assistance program.

INSURE MISSOURI UPDATE

After the conference committee on the budget zeroed out all funding for Insure Missouri last week, it appears that the Governor’s proposal to cover low-income working parents and guardians is dead. Although, the Senate passed SB 1283, the House has stalled on moving forward their own bill sponsored by Rep. Rob Schaaf because there is not enough support for one provision in the bill allowing hospitals to offer new or expanded services without state approval through the Certificate of Need program. The Certificate of Need process is intended to help ensure that new services proposed by health care providers are needed for quality patient care within a particular region or community. This provision is strongly supported by both Rep. Schaaf and the Speaker, Rod Jetton, but is opposed by the Missouri Hospital Association. The House appears to be unwilling to take up the Senate bill.

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FORUMS SCHEDULED TO DISCUSS MISSOURI’S CHILD CARE REGULATIONS

The Missouri Department of Health and Senior Services will hold a series of open forums in early June to get feedback on the State’s Child Care Regulation existing rules. The first set of rules identified for revision is the group home/center child care rules. Parents, child care providers, and advocates are encouraged to attend one of the following regional forums to discuss important regulations impacting the health and safety of Missouri’s children:

Monday, June 2--Kansas City

7:00 - 9:30 p.m.

Holiday Inn, 4011 Blue Ridge Cutoff

Tuesday, June 3--Springfield

7:00 - 9:30 p.m.

Ozark Technical College

815 North Sherman (211 Lincoln Hall)

Wednesday, June 4--Columbia

7:00 - 9:30 p.m.

Boone Electric Community Room

1413 Rangeline Street

Thursday, June 5--Cape Girardeau

7:00 - 9:30 p.m.

Southeast Missouri State University

Dempster Business Bld. Room 124

One University Plaza MS 5800

Saturday, June 7--St. Louis

9:00 - 11:30 a.m.

St. Louis Community College @ Florissant

Valley Multipurpose Room

3400 Pershall Road

Registration is not required. For questions, call the Section for Child Care Regulation at 573-751-2450.

KANSAS LEGISLATIVE UPDATE

Thanks to our partners at the Kansas Action for Children for this Update on the latest from Topeka.

CHILDREN’S INITIATIVES PROTECTED IN PROPOSED BUDGETS

Bipartisan efforts in both the House and the Senate have resulted in budget bills that will dedicate new Children's Initiatives Fund (CIF) dollars to early childhood education initiatives and fund the Early Childhood Block Grant that was originally proposed in the Governor's budget.

The House voted 64-60 late Thursday afternoon (May 1) to approve its version of the Omnibus appropriations bill. The bill included an amendment by Melody McCray-Miller (D-Wichita), which passed 66-56, that will preserve the use of CIF funds for children's initiatives and fund the Early Childhood Education Block Grant. An earlier version of the House bill called for utilizing new CIF dollars to cover budget shortfalls unrelated to children's initiatives.

The Senate voted 21-18 just after midnight (May 2) to pass its version of the Omnibus appropriations bill. The bill included an amendment by Sen. David Wysong (R-Mission Hills) that rolls back any increases in general fund spending from the Senate's bill, but preserves new CIF dollars for the Early Childhood Block Grant.

Budget negotiators from each Chamber will now meet to reconcile differences in the two budget bills.

"This is potentially a tremendous victory for Kansas children," Cindy D'Ercole, governmental relations director for Kansas Action for Children, told The Kansas City Star. "It demonstrates the support in both chambers for investing early, and continues the Legislature's commitment to utilize CIF dollars for early childhood programs."

LEGISLATURE APPROVES HEALTH REFORM PLAN THAT PUTS CHILDREN FIRST

The House and Senate today overwhelmingly approved a health reform package that will provide more Kansans with access to health care. A key component of the health reform package is an extension of the state's HealthWave eligibility limit from 200 percent to 250 percent of poverty.

The HealthWave component was spearheaded by Senate leadership, Sen. Susan Wagle (R-Wichita), and Kansas Action for Children. It will address the fastest-growing group of uninsured Kansas children - those living between 200 and 250 percent of poverty - by providing them with an affordable health care option.

"With today's action, Kansas is better positioned alongside our neighboring states," said Shannon Cotsoradis, executive vice president for Kansas Action for Children. "The Legislature has taken a tremendous step to provide Kansas children with the same opportunities for health coverage as children in other states."

Twenty-six other states have set eligibility levels for their children's health insurance programs above 200 percent of poverty. Both Missouri and Oklahoma have extended eligibility to 300 percent and, just last week, the Iowa Legislature voted to extend eligibility for its children's health insurance program to 300 percent of poverty.

HealthWave expansion is made contingent upon federal funding. Congress is expected to vote on funding for the State Children's Health Insurance Program (SCHIP) prior to March 2009. At that time, states anticipate the availability of increased federal resources.

"It's a good day for Kansas children," said Suzanne Wikle, director of health policy for Kansas Action for Children. "Working-class families across the state will soon have access to affordable health care for their children. It's a commendable first step toward health reform, and one that ensures a healthier future for the next generation of Kansans."

The approved health reform package also includes components focused on pregnant women and low-income Kansans.

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FEDERAL UPDATE

BILL INTRODUCED TO ADDRESS BOOTCAMPS

On April 24^th, Representative George Miller (D-CA) introduced the Stop Child Abuse in Residential Treatment Programs for Teens Act of 2008 (H.R. 5876) to better regulate boot camps and other alternative placement facilities and to bring transparency to the policies and practices of such programs.

The legislation is a response to numerous studies documenting the ineffectiveness of these programs and, in several instances, tragic deaths as a result of child abuse and neglect as reported by the Government Accountability Office in October 2007. GAO has issued a new report that was the basis of this hearing. The report examined selected cases of abuse, death, and deceptive marketing.

The legislation would prevent corporal punishment, physical abuse, and mental abuse. Programs would be prohibited from using disciplinary techniques that involve the neglect of essential food, clothing, shelter, or medical care. Programs could use physical restraint only when necessary for the safety of the child or others, and they would be required to provide children with reasonable access to a telephone and to train staff in what constitutes child abuse and neglect and how to report it.

H.R.5876 would require programs to disclose to parents the qualifications and responsibilities of all current staff members and to notify parents of substantiated reports of child abuse or violations of health and safety laws.

The bill includes an increase in authorized funding for the Child Abuse Prevention and Treatment Act from $120 million to $200 million for states to institute these initiatives, and a separate authorization of $50 million for the U.S. Department of Health and Human Services (HHS) to establish inspections and regulations.

The legislation is expected to be considered for approval by the full committee in the next few weeks.

CHILD ABUSE REGISTRY REQUIREMENTS BEING STUDIED

Section 633 of the 2006 Adam Walsh Child Protection and Safety Act (P.L. 109-248) includes a mandate to create a national child abuse registry based on current state child abuse registries. Creation of such a registry requires a study of HHS, and the Office of the Assistant Secretary for Planning and Evaluation (ASPE) recently announced it is conducting that feasibility study.

The legislation dealt with child predators for the most part, but it developed into a collection of various items, with some touching on child abuse and child welfare. The creation of a national child abuse registry creates several challenges state agencies and advocates have raised including the fact that state child abuse registries do not necessarily include individuals who have been convicted of any crime. Concerns also exist about how states differ in their definitions of child abuse and neglect, their standards for substantiation of abuse and neglect, differing requirements for an appeals process to remove an individual's name from such a list, how a national registry would be used, and who would have the authority to use it.

The law calls on HHS to "collect, in a central electronic registry, information on persons reported to a State, Indian tribe, or political subdivision of a State as perpetrators of a substantiated case of child abuse or neglect." In addition, HHS is to conduct a study on the feasibility of establishing data collection standards for a national child abuse and neglect registry before creating a registry. The study "shall include recommendations and findings concerning-- (A) costs and benefits of such data collection standards; (B) data collection standards currently employed by each State, Indian tribe, or political subdivision of a State; (C) data collection standards that should be considered to establish a model of promising practices; and (D) a due process procedure for a national registry."

Until Next Week –

Carrie & Emily

Policy & Outreach Coordinators

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