In Focus: Cultural Competency

Aug 2, 2016  |  PERMALINK »

California Child Care Proposals Promote Economic Stability

By Christine Johnson-Staub and Hannah Matthews

This month, California policymakers have an opportunity to realize the promise of the new federal child care law by enacting Assembly Bill 2150 (AB 2150). The state bill, which was passed unanimously by the  California Assembly and Senate Policy Education Committee, would strengthen child care assistance programs by supporting providers, improving stability for parents, and enhancing continuity of care for children. The next step is an August hearing before the Senate Appropriations Committee.

California’s bill would implement key provisions in the reauthorized federal Child Care and Development Block Grant (CCDBG), including a simplified eligibility process and improved stability of payments to providers. The goal is to make it easier for families to get and maintain assistance while also promoting the health, safety, and quality of child care.

AB 2150 comes on the heels of another state victory. The FY 2017 budget, signed into law by Governor Jerry Brown in July, repealed California’s Maximum Family Grant (MFG), a “family cap” policy that limited cash benefits for many low-income families. The budget also included $145 million in new early childhood investments, which will primarily be used to increase provider payment rates for subsidized child care. This is the first significant rate increase in years and will allow families to access a greater share of the child care market. Low payment rates make it financially unviable for providers to offer services for children receiving subsidies; as a result, families are limited in their child care options and many providers can’t afford to invest in quality or provide staff a livable wage.

The budget’s investment in payment rates is an important step in stabilizing California’s supply of child care as well as supporting those who provide it. However, additional funding and policy changes are needed to continue to improve the system.

AB 2150 would leverage key elements of the new federal CCDBG law to further improve financial stability for families and providers. For example, CCDBG now requires a minimum of 12 months’ eligibility (regardless of temporary changes in family income). In addition to providing continuity of care for low-income families, 12-month eligibility makes revenue more predictable for providers.

Beyond implementing these CCDBG provisions, AB 2150 would increase the income level at which families qualify for child care assistance by requiring that current census data be used to calculate eligibility. Further, the bill would allow families to remain eligible for child care assistance as their incomes increase up to 85 percent of current State Median Income (SMI), the federal income eligibility limit.

Taken in combination, these measures would go a long way toward strengthening California’s child care system, as the state suggested in its plan to federal regulators. That plan, which the Administration for Children and Families has conditionally approved, cites AB 2150 as the legislative vehicle for ensuring compliance with many provisions in the new federal law.

CLASP is encouraged by California’s efforts to expand and improve child care services for low-income children. The sheer number of needy  families— combined with a massive, complex child care system—will make it challenging to implement the new federal law, especially as it relates to cost. However, California stakeholders and policymakers have begun to rise to the challenge. Now, it falls on Governor Brown and the California Senate to make AB 2150 law and improve access to quality, affordable child care for low-income working families.

Read more about CCDBG implementation in states >>

Jul 21, 2016  |  PERMALINK »

Medicaid Expansion Helps Kids by Helping Moms Get Care for Maternal Depression

By Joan Alker and Olivia Golden 

Today, CLASP and Georgetown University Center for Children and Families (CCF) are releasing a new report on the important but often-overlooked link between adult health care coverage and children’s healthy development – specifically, the connection between health care coverage and identifying and treating maternal depression, so that children can thrive.  Because of the powerful connection between mothers’ mental health and children’s wellbeing and long-term success, Medicaid expansion is a critical tool to help children and should be front and center for child-focused advocates and policymakers. 

We are especially excited about this report because of the complementary expertise of our two organizations – CCF on health and CLASP on child care and early childhood development.  Thank you to our co-authors Stephanie Schmit and Alisa Chester for their hard work synthesizing the research about child development, Medicaid expansion, and maternal depression.  The report, Medicaid Expansion Promotes Children’s Development and Family Success by Treating Maternal Depression, distills the research to support four key conclusions.

  • Untreated maternal depression is a major public health problem that affects large numbers of women, especially low-income women and their children. More than half (55 percent) of poor infants have a mother who is experiencing some level of depressive symptoms. Maternal depression has been shown to undercut children’s healthy development and stymie families’ efforts to escape poverty. Maternal depression can affect children’s cognitive, socio-emotional, and behavioral development, as well as academic achievement and employment opportunities throughout their lifetime.
  • While safe and effective treatments exist, low-income and uninsured women are far less likely to get treatment. More than one-third (37 percent) of low-income mothers with young children who have had a major depressive disorder do not receive any treatment. The cost of mental health care is a major barrier to care, particularly for uninsured mothers.
  • States that used the Affordable Care Act (ACA) to expand Medicaid coverage for low-income parents have new opportunities to ensure that women are enrolled and receiving coverage. In the 19 states that have not expanded Medicaid, half a million mothers fall into a coverage gap. They earn too much to qualify for Medicaid coverage but earn too little to qualify for premium assistance through the ACA’s health insurance marketplace. The Medicaid income eligibility threshold for parents in most non-expansion states is extremely low. (See chart).
  • Mothers without health insurance face significant financial barriers to getting the care they need to treat maternal depression.  As research cited in the report demonstrates, expanding Medicaid coverage to more low-income adults (including mothers) would remove those barriers and help increase access to screening, identification, and treatment of maternal depression—thereby promoting young children’s healthy development and families’ economic security. Access to Medicaid has been shown to reduce the incidence of depression by increasing access to mental health services and diminishing financial barriers to care. For example, new research indicates that Medicaid expansion has not only resulted in improved access to medical benefits but has also resulted in improved access to behavioral health treatment for newly eligible enrollees.

The report concludes that Medicaid expansion for low-income mothers can greatly improve women’s access to treatment for depression, which is vital to children’s healthy development.

Extending Medicaid coverage to more low-income mothers would help increase screening, identification, and treatment of maternal depression—thereby promoting young children’s healthy development and family economic security.

If more states were to accept Medicaid expansion funding, more mothers would gain access to maternal depression screening and treatment and more children would have improved opportunities to reach their full potential.

READ MORE >>

Jun 16, 2016  |  PERMALINK »

The Family First Prevention Services Act—An Opportunity to Make a Positive Difference for Vulnerable Children and Families

By Stephanie Schmit

Update: The House passed the Family First Prevention Services Act on June 21 by voice vote. The legislation now moves to the Senate for further action. 

Yesterday, the U.S. House Ways and Means Committee marked up the Family First Prevention Services Act, which allows states to use federal child welfare matching funds for certain quality prevention investments for children and their parents and encourages the placement of children in foster care in the least restrictive, most family-like settings.

This bill is significant because funding for child welfare prevention to help keep children safely at home is capped under current law, while foster care payments are not.  This bill would take a significant first step towards providing matching funds for specified prevention services and programs.

Funding would be available for two types of prevention services and programs:

  1. Mental health and substance abuse prevention and treatment services.
  2. In-home parent skill-based programs, which include parent skills training, parent education, and individual and family counseling.

The bill makes these services available to children who are candidates for foster care, without regard to income. Specifically, children must have a prevention plan identifying them as being at imminent risk of entering care but who can safely remain at home or in a kinship placement if provided services that prevent entry into foster care.  Services can also be provided to children in foster care who are pregnant or parenting, and to the parents or kin caregivers of candidates for foster care where services are need to prevent entry into care and directly relate to the child’s safety, permanence or wellbeing. The bill specifies that services are available for a maximum of 12 months, but can be received more than once throughout different points in the child and family’s life.

These provisions are important because parental mental health and substance abuse are significant risk factors for children—but treatment has been shown to be effective.  States that expanded Medicaid eligibility under the Affordable Care Act also have additional capacity to provide prevention services because of the mental health and substance abuse services available through Medicaid. While Medicaid has the potential to reach much larger populations of at-risk parents and children than the specific group targeted by the Family First Prevention Services Act—and states should be acting now to take advantage of that potential—the new flexibility would allow states to develop more intensive, comprehensive programs for these specific families, including non-health components that go beyond what can be funded under Medicaid. 

The cost of the new services would largely be offset by reductions in states' ability to claim federal payments for putting children in inappropriate non-family foster settings, such as group homes and congregate care settings, which are less desirable options than family placement.  

This bill is not a comprehensive child welfare reform bill—in particular, it leaves federal foster care eligibility tied to the pre-welfare reform Aid to Families with Dependent Children (AFDC) eligibility standards, which means that fewer and fewer foster care cases qualify for federal funding each year.  However, the bill is an important step towards the goal of investing in prevention of harm to children and reducing the need for more costly later interventions.

The Family First Prevention Services Act was introduced with bi-partisan, bi-cameral support and was approved by the Ways and Means Committee. We urge Congress to pass this bill.  

READ MORE >>
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