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Focusing on a variety of education, health and youth development issues of importance to children and families in Pennsylvania.

CHIP Turns 25

On Saturday, December 2nd, we celebrated CHIP’s 25th birthday in Pennsylvania.

PPC President & CEO Joan Benso fondly remembers gathering in the State Capitol Rotunda to join Governor Casey as he signed the CHIP statute into law on that day in 1992. Lucy Hackney, PPC’s founder, stood proudly behind Governor Casey and then state Rep. Allen Kukovich and Sen. Alyson Schwartz – the bill’s prime sponsors. It was one of the greatest moments in PPC’s 25-year history.

CHIP has always enjoyed strong bi-partisan policymaker support. Five governors and countless state legislators have continued to champion CHIP over these many years and thousands of children have benefited.

Pennsylvania’s CHIP program served as the model for the national program – the State Children’s Health Insurance Program or SCHIP – when it was enacted in 1997. PPC helped lead the charge when our state-only funded program was enacted in 1992; in 1997 when the federal law passed; and when Pennsylvania passed Cover All Kids in 2006.

Joan says that in all her years advocating for children’s health care, she has yet to meet a state or federal lawmaker who doesn't think CHIP is a program that works, who doesn't think CHIP is a program worthy of public funds and who doesn't think that a strong CHIP program shouldn't be in place for Pennsylvania's children.

So why are the parents of 178,000 children who rely on it for their children’s regular doctor visits, vision, dental and prescription coverage worried? Because, if Congress doesn’t act quickly, the families of these children won’t be receiving holiday greetings in the mail, they will be receiving coverage termination notices.

Teresa Miller, Acting Secretary of the Department of Human Services, this week said she has a draft letter sitting on her desk informing families that their coverage is being terminated – a letter she hopes she never has to send.

Approximately 96% of Pennsylvania children have health insurance. More than 1.4 million or 46% of Pennsylvania children are insured through CHIP and Medicaid. The rate of uninsured children in our state has dropped by 20% in the last five years and this is in part to CHIP as well as the reforms driven by the Affordable Care Act.

Pennsylvania must continue its progress, not go backward and certainly not to the extreme of having to notify the parents of 178,000 kids that their children will lose CHIP coverage. There’s just no reason why Congress can’t get this done very quickly – funding for the program expired two months ago on September 30th.

We hope our Congressional delegation does the right thing and gives peace of mind to the parents of CHIP kids so that they see no disruption in health care services in the new year.

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Statewide Child Abuse Data Remains Constant in 2016

Last week, the Department of Human Services (DHS) released the 2016 Child Protective Services Report, formerly known as the Annual Child Abuse Report. Mandated by law, this report includes a statistical analysis of both child protective services (CPS) data and, new for the past two years, general protective services (GPS) data by county.

This year, the report was re-designed to be more user-friendly through the use of county specific pages providing snapshots of the data, rather than listing the data in tables containing all 67 counties’ information. In addition to CPS and GPS data, the report includes information on requested child abuse clearances, mandated reporter training, child fatality and near fatality incidents and human services expenditures.

Many of the data points remained relatively constant from 2015 to 2016. Notable statewide findings include:

  • 44,359 reports of suspected child abuse or neglect; 4,597 (10.4%) of which were substantiated. This is an increase of about 2,000 from the most recent 2015 data, however, the rate of substantiation remained nearly the same – from 1.6 per thousand children in 2015 and 1.7 per thousand children in 2016.

  • Of these substantiations, 3,078 included reports of suspected sexual abuse, 1,920 included reports of suspected physical abuse, and 539 included reports of suspected serious physical neglect;

  • 951,414 total child abuse history clearance applications submitted. Of these requests, the state identified 2,272 applicants as substantiated or alleged child abuse perpetrators (2,224 were found on file as perpetrators or alleged pending an investigation/court determination of abuse in 2015);

  • 359,802 FBI criminal history checks submitted. Of these requests, 836 persons with a record identified were for crimes that would disqualify an applicant from working or volunteering with a child;

  • 151,087 total allegations of General Protective Services (GPS) concerns. Of these, 31,649 (21%) were found valid. Of valid reports, 13,206 reports included parental substance abuse as an allegation (may have more than one allegation in a report).

  • 166,971 calls received at ChildLine, with 10,957 (6.6%) having been abandoned (42,000, or 43% of total calls to ChildLine, had been abandoned or neglected in 2015, noted previously).

To access the newly-designed report and compare your county across the state, click here.

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April is National Child Abuse Prevention Month

Each April, we take time to recognize the important ways individuals and communities can come together to prevent child abuse and neglect. As National Child Abuse Prevention Month, we are joined in doing so by many like-minded organizations across the country.

This year, in addition to offering some tangible ways you can take action to protect children and support families in your own community, we also acknowledge the creative efforts by Pennsylvania’s Department of Human Services to support you in this important work. The KeepKidsSafe website has released powerful radio advertisements, educational videos, and printed materials you can use to raise awareness and educate your friends and family on reporting child abuse and neglect, as well as getting the necessary clearances to work and volunteer with children.

Here are the ways you can get involved in 2017’s National Child Abuse Prevention Month:

  • Save and share the ChildLine number – 1-800-932-0313. It’s a toll-free number for Pennsylvania’s child abuse hotline. The line is open 24 hours a day, seven days a week, and reports can be made anonymously. Give the number to friends, family and colleagues who might not have it in their phones. Remind them that anyone can (and should) report suspected child abuse or neglect.
  • Call ChildLine to report suspected abuse or neglect. If you’re a mandated reporter, remember: you can call or make your report online.
  • Visit the KeepKidsSafe website, here, to watch the new media resources mentioned above. Be sure to share the resources with your networks. This is a simple step we can all take to protect the children in our neighborhoods. Use the hashtags #KeepKidsSafe and #MakeTheCall on your social media accounts.
  • Visit the National Child Abuse Prevention Month website, here, to find additional useful resources to help promote the initiative.
  • Sign up for PPC’s email alerts, here, to be a voice for kids and stay up to date on the latest news in child welfare in PA.

We hope you’ll join us in these actions throughout April, in an ongoing effort to ensure all of Pennsylvania's children are raised in loving and knowledgeable families, free from abuse and neglect.

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Data Shows Decrease in Size of PA's Child Welfare System

Each year, Pennsylvania Partnerships for Children gathers comprehensive child welfare data on each of the state’s 67 counties in an effort to analyze the commonwealth’s performance when it comes to ensuring children are raised in loving and knowledgeable families free from abuse and neglect. Since 2013, PPC has been able to monitor the state’s performance over time, by comparing data from the previous five years.

The 2017 State of Child Welfare report, released today, highlights two important improvements to Pennsylvania’s child welfare practice.

For the first time since 2012, the number of children entering foster care in Pennsylvania was lower than the number of children exiting the system in the same year. Put simply, this means the size of the child welfare system is declining. In a year where the reports of suspected child abuse and neglect increased by 38%, this demonstrates not only Pennsylvania’s commitment to a permanent family for children and youth who experience child welfare placement, but also a commitment to ensuring families at-risk of child welfare involvement are supported through services that seek to prevent abuse and neglect in the first place, such as in-home services and other family strengthening efforts.

This year’s report also includes an important new data set – General Protective Services (GPS) data. For the first time, data on GPS reports –  which include reports of general neglect such as parental substance abuse, truancy or parent-child conflict concerns – are being collected by the Department of Human Services rather than at county children and youth agencies. The GPS system is an important part of our child welfare system. It helps identify and prevent problems before they occur. By intervening in high risk situations before an indication of abuse occurs, the GPS system is able to provide and refer targeted services to families in need.

Other highlights from this year’s report include:

  • Continued increased in reports of child abuse and neglect, as this data reflects the first full reporting year following the passage of over two dozen child protection laws;

  • Continued increase in family-based placements for youth in foster care, which is now at its highest percentage in five years;

  • An increase in congregate care placements for children and youth who re-enter the foster care system after being reunified with their families.

Looking ahead, Pennsylvania needs to continue its success in working to prevent the need for out-of-home care, but when that is not possible, we need to ensure family-based placement and permanent adult connections are provided to children and youth who are removed from their homes. Additionally, we need to prioritize increasing family-based placements for older youth and youth who re-enter foster care. Youth between the ages of 12 and 17 are more likely to leave the foster care system without a permanent family, putting them at risk of various poor outcomes in adulthood such as homelessness or unemployment.

To view the full 2017 State of Child Welfare report, as well as individual county-level reports, click here.

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National Home Visiting Coalition Announces Website Launch

The National Home Visiting Coalition, a group consisting of nearly 50 advocacy and home visiting programs, announced the launch of its new website last week. The Coalition is urging Congress to reauthorize and expand the federal Maternal, Infant and Early Childhood Home Visiting (MIECHV) program, which is set to expire in September.

The website provides answers to frequently asked questions, reports, and fact sheets regarding home visiting, as well as presents opportunities for constituents to contact their federal delegation to encourage their continued support for evidence-based home visiting programs.

Home visiting programs provide essential one-on-one support to families from pregnancy through early childhood, focusing on improving the physical and mental health of families, ensuring access to quality health care and resources, and partnering with parents to support children’s education. Home visitors can be nurses, social workers or other trained educators, who work with families directly in their homes. Last Wednesday, a nurse-home visitor and parent from Nurse-Family Partnership in Lancaster testified about their experiences with the program at the U.S. House Ways & Means Committee hearing on the reauthorization of MIECHV. You can read their testimonies here.

Currently, MIECHV is the largest home visiting funding source in Pennsylvania, funding four unique, evidence-based models – Early Head Start; Healthy Families America; Nurse-Family Partnership; and Parents as Teachers. Governor Wolf included a home visiting initiative is his proposed 2017-2018 budget for evidence-based home visiting programs for a second year in a row. His proposal will substantially build upon the state’s current home visiting funding and could serve 1,700 more families. In order to ensure these essential services are provided to Pennsylvania’s most at-risk families, PPC supports both the reauthorization of the MIECHV program and Governor Wolf’s budget proposal.

To learn more about evidence-based home visiting programs and take action to ensure the reauthorization of the MIECHV program, visit the National Coalition on Home Visiting’s new website here.

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House Health Care Bill Retains ACA Provision for Foster Youth

On Monday, the American Health Care Act was introduced in the House of Representatives as a replacement for the Affordable Care Act (ACA). PPC expressed concerns regarding many of the bill’s provisions and the effect they would have on our nation’s children, including a per capita cap for Medicaid, rolling back Medicaid eligibility for children based on family income, and reducing the federal share of Medicaid expansion costs – all of which would limit federal funding and leave states at risk if costs for services grow more than inflation.

One bright spot? Continued coverage for young adults aging out of foster care. As noted previously, another aspect of the ACA that affects kids was the ability of children to stay on their parent’s insurance plans until age 26, which also made Medicaid available to foster youth until the same age. This provision was included in the American Health Care Act as introduced Monday, and has so far survived mark up by the House Ways and Means Committee and the House Energy and Commerce Committee.

PPC will continue to monitor the bill, any amendments, and their effect on children and youth in Pennsylvania. To view the bill text, click here.

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Pennsylvania Commits to Continued Medicaid Coverage for Former Foster Youth

As we’ve noted, Pennsylvania is one of 14 states that extends Medicaid health insurance coverage until age 26 to youth who have aged out of the foster care system in another state. Last fall, the Center for Medicaid and CHIP Services released a bulletin detailing the steps a state must take to continue to offer this coverage, which is allowed under Section 1115 of the Social Security Act. In January, the Department of Human Services held a public meeting in which it was announced that the state would continue to support Pennsylvania young adults who have aged of foster care, regardless of what state they’re from, by completing the necessary waiver application.

The 1115 waiver plan, due in May, will ensure that the 18 former foster youth from other states currently covered under the Medicaid state plan will continue their coverage, and ensure additional youth who move to PA will be eligible for coverage as well.

To protect the overarching Medicaid to 26 provision of the ACA, our partner, Juvenile Law Center, recently collected signatures from current and former foster youth affected by the provision. The signatures were added to a letter to Congress, asking members to ensure that this provision is protected as efforts to change health care law are undertaken in the coming months. In addition to the letter, on Wednesday, signers and other supporters of the ACA were encouraged to participate in a national “call in day”, calling their Representatives and Senators to explain how the law affects current and former foster youth, and why it’s important to save it.

Here in Pennsylvania, over 700 youth aged out of the foster care system in 2016, while over 20,000 did so nationally. These young adults are more likely than their peers to experience health issues requiring medical insurance coverage due to the experiences in and prior to foster care, such as exposure to trauma, abuse and neglect.

The state has already committed to providing this vital coverage to all former foster youth in Pennsylvania, regardless of where they spent time in care. The call in day and letter, which can be found here, argue that our federal government should do the same. 

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How the Governor's 2017-18 Budget Proposal Affects Kids

On Tuesday, Governor Wolf presented his 2017-2018 budget proposal, using a different approach to addressing the state’s growing fiscal deficit: rather than proposing a broad-based tax increase, his plan instead calls for notable changes to the operations of state government, including merging the Departments of Human Services, Health, Aging and Drug and Alcohol Programs into one entity, which would be called the Department of Health and Human Services.

The Governor’s proposal includes the following investments that affect children and youth in the Commonwealth:

  • $65 million in additional funding for the state’s Pre-K Counts program and an additional $10 million for the Head Start Supplemental Assistance Program.
  • An additional $9 million investment in evidence-based home visiting programs that would support 1,700 additional families.
  • A $35 million increase in state funds for child care - including $10 million that will make it possible for 1,800 kids currently on state waiting lists to enroll in a child care program.
  • A $100 million increase for Basic Education Funding to be driven out through the newly-enacted student-weighted formula that would increase the state’s fair share of providing basic education services to students.
  • An increase of $25 million for special education funding through the enacted Special Education Funding Formula.
  • An increase of more than $57 million designed to meet the goals of county child welfare needs based budgets.
  • Continued state funding for both the Medicaid and the Children’s Health Insurance Program (CHIP).

You can find PPC’s full coverage of the budget proposal including all line items related to children’s investments here.   

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What’s Next for Child Welfare in 2017

The coming year is expected to be busy for federal programs and policies that affect children which, in some cases, will subsequently effect state legislative work as well. As we wrote last week, attempts to repeal and replace the Affordable Care Act may negatively affect not only children and youth in foster care, but also biological, resource and adoptive families who receive supports through grants at risk of elimination.

Additional topics of interest for lawmakers, child welfare professionals and advocates alike include home visiting programs, child welfare finance reform, and educational stability provisions for foster youth. See below for what’s next in 2017 for these three priorities:

Home Visiting

The federal Maternal, Infant, and Early Childhood Home Visiting (MIECHV) program will be up for reauthorization in 2017. Here in Pennsylvania, four evidence-based home visiting models are currently funded through the MIECHV program: Early Head Start; Healthy Families America; Nurse-Family Partnership; and Parents as Teachers. In these services, nurses and other trained professionals visit families with infants and toddlers to provide parent education and support and promote their children’s health, well-being, learning and development. In March 2010, Congress authorized the creation of the MIECHV program to promote evidence-based home visiting programs that strengthen health and development outcomes for at-risk children and their families. Originally authorized for five years, Congress extended MIECHV funding for two additional years in 2015; absent Congressional action, MIECHV will expire in September 2017. PPC will not only continue to pursue federal reauthorization, but also advocate for an increased state appropriation to better support these services in the commonwealth in 2017 and beyond.

Finance Reform

Federal child welfare finance reform was a national topic of conversation in 2016 with the roller coaster development of the Family First Prevention Services Act (FFPSA). Passed unanimously in the U.S. House in June, the bill subsequently died in the U.S. Senate, before undergoing two seeming resurrections through the 21st Century Cures Act and the Continuing Resolution (the provisions did not make it into the final iteration of either). The FFPSA makes needed and important reforms to many federal child welfare financing mechanisms to support prevention efforts and reduce congregate care placements for foster youth. It seems likely we will see a new version of the FFPSA in early 2017, but it remains to be known what form it may take as many of the cost-savings provisions were only possible if passed during this recent legislative session. PPC fully supports efforts targeted at reducing the use of congregate care and increasing family-based placements for youth in foster care, and will continue to support the bill’s re-introduction and passage in 2017.

Educational Stability

On December 10, 2016, provisions included in the federal Every Student Succeeds Act (ESSA) that affect students in foster care went into effect. As we noted previously, a portion of the law requires states to allow these students to remain enrolled in their same school when entering foster care or experiencing a placement change, unless remaining in the same school would be a risk to the child's safety or well-being. Local education agency transportation plans are due to the Pennsylvania Department of Education by January 31, 2017, which will outline exactly how school districts and child welfare agencies plan to coordinate to ensure students in foster care are not only provided school stability, but are also provided transportation to their original school as needed. Pennsylvania failed to codify any of the federal law into state statute, though amendments to Title 42 passed in the Senate this fall. PPC will continue to monitor the need for such legislation in 2017, and ensure the ESSA is being implemented to its full fidelity, ensuring foster youth receive the right of a safe and stable school placement.

Projecting activity between sessions is a challenge, particularly in years of a presidential transition. While we can’t predict what will happen in 2017, PPC remains committed to working to enact policies and programs that ensure all children are raised in loving families free from abuse and neglect.

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New Videos Help to Prepare Families for Post-Permanence

The Quality Improvement Center for Adoption and Guardianship Support and Preservation (QIC-AG) - a five-year project to test and implement interventions that achieve long-term, stable permanence in adoptive and guardianship homes – recently released two videos to create awareness of the need to support families not only in the pre-adoptive or guardianship stage, but continuing after permanency has been achieved.  

The first video describes a “continuum of service needs” which the project describes as a “way to visualize a family’s lifelong adoption or guardianship journey”.  In order to maintain family stability and promote healing for children who have experienced trauma, families’ must receive services along this continuum – preparation prior to the child’s placement, support during the child’s placement, and continuing support after the placement is finalized. The continuum framework includes eight intervals that represent various needs that might appear for the family adopting or providing legal guardianship to a child in foster care.

 

Both placement instability and experiencing trauma have been linked to a number of negative outcomes for youth, such as increased behavioral symptoms, lower academic achievement and poor developmental, social, and emotional functioning in adulthood. By recognizing the need to strengthen ongoing permanency services for these children and ensure these services do not end once permanency in achieved, the QIC-AG is taking a vital step forward in ensuring all children in foster care not only become part of a permanent family, but thrive throughout their lives.

The QIC-AG project is working across eight sites to implement eight different interventions with the ultimate goal to replicate and/or adapt the interventions to other states if proven effective. The second video describes the project sites more in-depth; together, the videos provide a powerful way to raise awareness among the public of the need to continue serving these families after permanency is achieved.

To watch both videos and share with your own networks, click here.

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