In Focus: Cultural Competency

Mar 1, 2017  |  PERMALINK »

President Trump Wants to Help Working Families, But Which Families?

By Hannah Matthews and Liz Ben-Ishai

The United States is long overdue in embracing policies that would make it easier for working families to both do their jobs and care for their families. In his first speech to Congress, President Trump expressed his desire to make child care affordable and ensure new parents have access to paid family leave. Unfortunately, his campaign promises and proposals to-date do little to advance public policy in these areas and run counter to getting help to those who need it the most.

In the United States, just 14 percent of civilian workers have access to paid family leave to care for a new child or seriously ill family member—and only four percent of the lowest-income workers have access. While a growing number of states (now five) have passed paid family leave laws, workers in most of the country are often forced to choose between caring for their families and their economic security. Moreover, only about 60 percent of workers are eligible for unpaid, job-protected leave under the Family and Medical Leave Act (FMLA), the only federal leave law. But of those parents who are eligible for FMLA, fewer than 40 percent can afford to go without pay while taking leave. In addition, just 38 percent of workers have access to medical leave to address their own serious health issues.

Parents everywhere struggle to pay the high costs of child care but none more than the lowest-income earners. On average, low-income parents who pay for child care spend 30 percent of their household budget on child care expenses, compared to just 7 percent for higher-income families. The vast majority of low-income families—85 percent—who could qualify for federal child care assistance to help with the staggering costs of care get no help because state and federal governments have failed to invest sufficiently in the Child Care and Development Block Grant (CCDBG), our country’s primary child care assistance program. 

Trump’s plan would do little to address our policy failures for working families. In his address last night, Trump professed a desire to provide paid family leave for new parents. During his campaign, Trump proposed a plan that would offer too few weeks of leave and provide too little wage replacement to make the program viable for low-income families. It also left out other important caregiving and health needs of today’s working families; millions of workers need to be able to care for seriously ill family members (not just new babies) and recover from their own illnesses without risking their economic security. Trump also proposed a financing mechanism—relying on dollars from fraud in the unemployment insurance system—which would not only be insufficient to support the (already inadequate) proposal, but also raise numerous challenges for implementation.

Instead of this poorly designed approach, the president should support the recently introduced Family and Medical Insurance Leave (FAMILY) Act, a federal bill that proposes an inclusive policy modelled on successful state programs. It would enable workers to take up to 12 weeks of paid leave to bond with a new child, care for a seriously ill family member, or recover from their own serious illness. The program would be funded with small contributions from employers and employees, using a social insurance model that is particularly appealing to small businesses.

Trump’s child care proposal is no less flawed. His plan—the bulk of which is a tax deduction proposal for child care expenses—is inherently regressive with the largest benefits going to wealthy families. (This is within the context of a tax reform agenda that would even further advantage the wealthy and corporations and reduce government revenue for funding critical programs and services.) Because most low-income parents do not earn enough to have federal tax liability, they would not benefit at all from this part of the plan. The proposal includes other tax savings mechanisms that also advantage the wealthy and are virtually unusable for low-income families. To address the child care needs of low-income families, Trump’s plan offers a child care “rebate” for low-income families. The rebate would cover just a small share of child care expenses, less than 8 percent, and the size of the benefit would pale in comparison to what higher-income families would receive from other components of the proposal. Moreover, a rebate will not help low-income families pay unaffordable child care bills upfront.

Trump’s plan falls far short of addressing the critical problems of child care affordability and quality.  Families need help affording child care. But paying for child care is only part of the problem. Tax strategies will do nothing to advance quality improvements necessary to ensure that children have access to enriching settings. Central to quality is the child care workforce, who despite the high costs of care, earn very low wages. The best way to help low- and moderate-income families and improve child care quality for all children is investing in CCDBG, which provides direct assistance to help families afford the high cost of child care. CCDBG also builds the quality of child care by providing funds to states for quality improvement activities, including monitoring compliance with critical health and safety standards, and for the training and professional development of child care and early childhood educators.

Investing in affordable child care and paid family and medical leave should be a national priority. Together, these critical supports for working families add up to a strategy that is good for children, families, employers, and our economy. Congress and the President should acknowledge the real challenges of working families and find solutions that help those most in need—and who have the most to gain.

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Feb 27, 2017  |  PERMALINK »

Top Five Ways ACA Repeal and Medicaid Financing Changes Would Harm our Youngest Children

By Stephanie Schmit and Elisabeth Burak

This item is cross-posted with Georgetown University's Center for Children and Families' health policy blog Say Ahhh!.

Leaders in the early childhood community understand that young children need a full system of supports in health, education, and other social services to enter school ready to learn and grow up to reach their full potential. Access to health care is a fundamental need for children, and access for their parents has a significant impact on children’s well-being, too. Congress is actively working to repeal the ACA and radically restructure, or limit, federal Medicaid funding, either through a block grant or per capita cap. Both block grants and per capita caps would limit federal contributions to Medicaid, shifting costs to states and forcing them to make hard decisions about who to cover and where to make cuts. (History shows this is not a great idea.) If passed, both the ACA repeal and efforts to restructure Medicaid could harm young children in the many ways; here are the five most troubling:

  1. Many parents and children would lose health care coverage. ACA repeal would mean that the number of uninsured parents and children would more than double by 2019, based on loss of Medicaid expansions, marketplace coverage, and confusion over who does and doesn’t have access to coverage. Restructuring Medicaid and/or failure to extend the Children’s Health Insurance Program (CHIP) would accelerate these coverage losses. Ultimately, ACA repeal and/or proposed Medicaid changes would reverse course on the historic gains in coverage that Medicaid, CHIP, and the ACA have made for children and families. Because parents’ and children’s well-being is so inextricably linked, the loss of access to necessary health and mental health services can have long-term, dire consequences for them both.

  2.  No guarantee of coverage for all children. Medicaid or CHIP covers 45 percent of all children under 6. Under Medicaid’s current structure, states receive federal contributions for the health costs of any person eligible. A block grant or cap would put a fixed limit on federal contributions, leaving states with difficult decisions about making up the costs by diverting funds from other programs or making cuts to eligibility.

  3. No assurance of comprehensive benefits for children. Medicaid’s benefit package for children, known as Early and Periodic, Screening, Diagnostic, and Treatment (EPSDT), helps families afford the care and early intervention their children need to meet developmental milestones. Endorsed by the American Academy of Pediatrics, EPSDT ensures children receive the screenings and treatments to identify and treat delays or diseases as early as possible. For example, catching hearing problems and addressing with a hearing aid  has a direct impact on a young child’s success at school. Block grants and caps proposals seek to provide states with more  flexibility, meaning they would choose what benefits children can receive and how to spend limited funds. This could likely result in eliminating the federal benefits guarantee that all children have today regardless of the state where they live. Ultimately this means that politicians, not pediatricians, will decide what services are necessary for children’s health and development.

  4. Threatens financial security for families and erects new barriers to care.  When the burdens of unexpected health problems and related costs are lifted through health coverage, the whole family has greater financial stability. With less federal funding and more flexibility to make cuts, states may impose additional premiums or cost-sharing (e.g., higher deductibles and co-payments) on Medicaid beneficiaries—requiring them to pay more to ensure their children get the care they need.

  5. Other state systems that serve young children and their families could take a hit. Medicaid is the single largest federal funding source flowing into state budgets. For perspective, the program represents more than K-12 education, higher education, public assistance, transportation, corrections, and many others combined. Restructuring Medicaid financing through a block grant or cap would shift costs to states, leaving fewer federal, and, ultimately, state dollars to meet the needs of children and their families. Pressure to meet healthcare costs could force states to make cuts in other parts of the budget that impact children, undermining universal Pre-K, education reform, or other proposals. Even as child and family advocates come together to support families in need, proposals like block grants or per capita caps could pit programs against each other for scarce resources while children and families remain in need.
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Feb 13, 2017  |  PERMALINK »

Trump’s Immigration Raids: An Attack on Our Nation’s Children

By Wendy Cervantes

This article was originally published on Medium.

Over the years, I’ve had the opportunity to meet some incredible young heroes in my work as an advocate for immigrant kids and families. One of these heroes, Zury, just turned 6 last week. But rather than focus on celebrating her birthday, Zury and her siblings Roberto (10) and Luna (12), both U.S. citizens like her, have spent the past few weeks anxiously awaiting their mom’s annual check-in appointment with U.S. Immigration and Customs Enforcement (ICE) scheduled for Wednesday February 15th.

ZuryZury and her siblings have been advocates since a young age, participating in immigrant rights rallies in their hometown of Denver as well as in Washington, D.C. Last year they even starred in a national PSA campaign aimed at highlighting the impact of immigrant enforcement on children. Therefore, they are all too familiar with the anxiety surrounding their mother’s annual check-in. But this time is different because last month President Trump issued an executive order that now makes their mother a priority for deportation. 

So, like millions of children around the country like them, Zury and her siblings are afraid.

Unfortunately, their fear is not unfounded. Last week the deportation regime promised by President Trump during his campaign was unleashed, creating chaos among whole communities. Contrary to the President’s former claim that he would primarily focus on deporting so-called “criminal aliens,” parents and other long-time residents have now become targets as well. The raids that swept through homes and workplaces across the country last week resulted in the detention and deportation of hundreds of immigrants, including many who had only committed minor violations or were simply taken into custody as bystanders unable to provide documentation. In the aftermath, children and families have been left to question their safety in the communities they love and call home.

The fact that a much larger group of immigrants are now being targeted is a reflection of controversial aspects of the president’s executive order. For example, the order significantly broadens the scope of enforcement priorities that previously safeguarded many parents and long-time residents whose only violation was living in the country without documentation. In fact, one of the first immigrants to be deported following the order’s introduction was Guadalupe Garcia de Rayos, mother of two U.S. citizen children, who was immediately apprehended and detained during her annual check-in with ICE in Phoenix.

Cases like Guadalupe’s and disturbing reports of ICE agents allegedly following school buses during last week’s raids also raise concerns over the Trump Administration’s adherence to existing protocols—-all of which have broad bipartisan support—-designed to mitigate the collateral harm to children as a result of immigration enforcement.

For example, a 2013 ICE policy known as the “parental interest directive” instructs ICE personnel to consider the use of prosecutorial discretion in cases involving a parent or legal guardian of a U.S. citizen or Lawful Permanent Resident minor child, as well as the primary caregivers of a minor (regardless of the minor’s immigration status). The directive also instructs ICE personnel to ensure that parents and legal guardians subject to deportation are able to make decisions regarding their child’s care, such as arranging guardianships or coordinating travel for their child to accompany them at the time of removal. Another critical policy restricts ICE’s ability to conduct enforcement actions in places considered “sensitive locations” such as schools, child care centers, hospitals, and places of worship in an effort to prevent fear of enforcement from deterring children and families from their daily routines.

The harm suffered by children who are separated from a parent due to deportation—or who simply live in fear of separation—are well documented, including impacts to their mental and physical health, economic security, and school performance.  Research shows that kids who witness their parent’s arrest, such as those present during last week’s home raids, are much more likely to suffer long-term behavioral changes. Children whose parents are detained or deported are also at risk of unnecessarily entering the child welfare system, an outcome that can have particularly dire consequences. Such consequences could become much more common if ICE fails to adhere to policies like the parental interest directive, which also provides specific protections for parents with children in the foster care system.

Make no mistake about it: Trump’s raids are not about getting tough on criminals. They are about terrorizing children, families, and communities. Kids like Zury represent the future of our country, and we are no safer or better off when any child is put in harm’s way. In America, no child should have to live in fear of losing a parent, and the president must be held accountable for ensuring his new policies do not needlessly traumatize our youngest citizens or tear families apart.

See NILC’s Know Your Rights materials for immigrant communities

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