Read this week’s federal update for the latest on: 

  • New Proposed Rule Regarding Faith-Based Regulations
  • Series of Hearings on Administration Actions that Threaten the Welfare of Children
  • Medicaid Block Grant Proposal Announced by CMS
  • Supreme Court Approves “Public Charge” Rule
  • Family Leave and Child Care Hearing in the House of Representatives
  • Children’s Bureau Releases Child Maltreatment 2018
  • Government Accountability Office Report on Barriers to Treatment for Opioid Abuse and Addiction in Medicaid

New Proposed Rules Regarding Faith-Based Regulations

A few weeks ago, the Trump Administration announced nine new proposed rules that would significantly change the existing regulations that govern the partnerships between the government and faith-based social service providers, such as World Vision, Catholic Charities, and more. This Department of Health and Human Services (HHS) proposed rule doubles down on last November’s rule revoking HHS’ nondiscrimination provisions, by removing requirements to refer program recipients to secular agencies if needed, allowing employment discrimination based employees adherence to religious tenets (such as Miracle Hill Ministries’ statement) and more. The Coalition Against Religious Discrimination has created guidance for responding to the proposed rule, which is available here. Comments are due Feb. 18. 

Source: Child Welfare and Mental Health Coalition

Series of Hearings on Administration Actions that Threaten the Welfare of Children

On Feb. 5 and 6, the House Committee on Oversight and Reform conducted an in-depth, two-day series of hearings held by four of its subcommittees to examine the negative effects of regulations proposed by the Trump Administration relating to children. This unique and extensive series of hearings assessed the impact of the Administration’s actions on child poverty, housing, hunger, and health. Topics of the hearings included: 

  • The Trump Administration’s Proposed Changes to the Poverty Line Calculation 
  • The Trump Administration’s Proposal to Gut Fair Housing Accountability
  • The Trump Administration’s Proposed Changes to Broad Based Categorical Eligibility for the Supplemental Nutrition Assistance Program 
  • The Trump Administration’s Proposal to Undermine Protections from Mercury Air Toxics Standards.

Source: Child Welfare and Mental Health Coalition

Medicaid Block Grant Proposal Announced by CMS

On Jan. 30, the Centers for Medicare and Medicaid Services (CMS) revealed a new program, called Healthy Adult Opportunity (HAO) , that would implement spending caps within the Section 1115 demonstration waiver program, which sponsors experiments and pilot projects for Medicaid. HAO’s defenders argue that the program will give states more flexibility to design their own Medicaid programs and incentivize states to invest in innovation to deliver high quality health care at lower cost. A statement from patient groups , however, warned that this new guidance is designed to reduce federal funding for Medicaid and will lead to lower enrollment, less benefits, and more cost-sharing for patients. The new guidance will also allow states to pick and choose which drugs their plans would cover; currently Medicaid covers all drugs. The administration has opened the process for states to submit applications for HAO. It is not clear which states will opt for this type of block grant yet, though Oklahoma Gov. Kevin Stitt spoke at the announcement ceremony and lauded the program.

Supreme Court Approves “Public Charge” Rule

On Jan. 27, the Supreme Court ruled in favor of the Administration’s “public charge” rule , which will expand the power of the Department of Homeland Security (DHS) to deny some immigrants access to the country or change in status. After being held up in several lower court injunctions, the Supreme Court ultimately found that DHS should have the ability to consider an applicant’s past participation in public programs, including Medicaid, SNAP and Section 8 housing benefits, when determining whether the applicant could rely on public benefits in the future. The rule will also allow DHS to consider an applicant’s age, health, family size, education, skills, and financial status to deny green card applicants, laying the groundwork to deny applicants based off potential, rather than past, engagement with the safety net. DHS announced the rule will go into effect on Feb. 24, 2020.

Family Leave and Child Care Hearing in the House of Representatives

On Jan. 28, the House Committee on Ways and Means hosted a hearing on the Family and Medical Insurance Leave (FAMILY) Act , which would provide up to 12 weeks of partial income to families for the birth or adoption of a child, or the serious health condition of a child, parent, spouse, or domestic partner. The bill would be funded by a small increase in payroll contributions ($2 per week for a typical worker). In the US, 1 in 4 women return to work ten days after giving birth. The hearing panelists praised the act as a much-needed solution to this problem. They discussed similar state level models in California and Oregon. For instance, the Oregon iteration includes full, rather than partial, income replacement for low-income families. Some panelists said that the FAMILY Act’s payroll tax structure is regressive, as the money lost to taxes matters more to low-income workers than high income workers. Other recommendations press for recognition of LBGTQ+ and multigenerational families. By the end of the hearing, the act seemed to be building bipartisan support. Representative Mike Kelly (R-PA) said, “this is not a Republican or Democrat issue; this is an American issue.”

Source: Child Welfare League of America

Children’s Bureau Releases Child Maltreatment 2018

The Children’s Bureau released Child Maltreatment 2018 , the annual report providing data on child neglect and abuse in the United States. This year’s report is also the first to include a special focus chapter, which includes new data elements for sex trafficking and infants with prenatal substance exposure. Key findings from this year’s report include: The national rounded number of children who received a Child Protective Services (CPS) investigation response or alternative response increased 8.4% from 2014 (3,261,000) to 2018 (3,534,000). The number and rate of victims have fluctuated during the past 5 years. Comparing the national rounded number of victims from 2014 (675,000) to the national rounded number of victims in 2018 (678,000) shows an increase of 0.4%. For 2018, an estimated 1,770 children died of abuse and neglect at a rate of 2.39 per 100,000 children in the national population.

Source: National Child Abuse Coalition

Administration for Children and Families Issues New Memo on Family First Transition Act

The Administration of Children and Families (ACF) recently released an informational memorandum about the Family First Transition Act, which passed last December. This memo gives states information about how to access additional funding and outlines some of the provisions of the act. This transition act provides $500 million in additional flexible funding to states for Family First implementation, it phases in some of the requirements around the clearinghouse for evidence-based practices, and it provides relief to states who were operating under IV-E waivers.

Source: American Public Human Services Association

Government Accountability Office Report on Barriers to Treatment for Opioid Abuse and Addiction in Medicaid

The Government Accountability Office (GAO) released a report recently, highlighting some of the barriers within Medicaid that restrict access to effective treatments in the fight against opioid abuse. The report focuses on the use of medication-assisted treatment (MAT), a proven method to reduce opioid abuse. Coverages of MATs are required by federal law, but GAO found that about 40% of states fail to deliver coverage. Other barriers identified included the complex waiver process and pre-authorization requirements that delay care. 

Source: American Public Human Services Association