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

How Repealing the ACA Affects Children and Youth in Foster Care

As we have previously noted, the Affordable Care Act (ACA) contains a key provision for youth aging out of foster care – under the law, states are required to provide Medicaid health insurance coverage for youth who were in foster care in their state, up until age 26. This policy mirrors the ability of youth not in foster care to stay on their parent’s health insurance until the same age. Pennsylvania even goes a step further and provides this coverage to young adults who aged out of foster care in another state.

Recent proposals by Congress and President-elect Trump to repeal the ACA and convert Medicaid into a block grant would strip this right from youth who are already at risk of experiencing various negative adult outcomes. Research shows that youth who age out of foster care are at greater risk of unemployment and homelessness than their peers who don’t experience foster care. Continued health coverage protects these same young adults from these risks.

Further, while a block grant may sound like a simpler way to fund the Medicaid program, this action risks destabilizing state budgets. A capped federal payment for these services doesn’t take into account the flexibility required should we face another recession, or the increase in health care needs of an aging baby boomer generation. States may find themselves cutting costs that hurt children and youth the most – such as prevention and other nonprofit children and family services – or freezing state staff hiring when these positions are vital to the health and well-being of children in state care, when faced with budget cuts in order to meet any unexpected increased need.

Child welfare agencies have long relied on Medicaid coverage for youth in foster care, and some states, including Pennsylvania, have expanded the program to cover low-income adults. Birth parents who receive substance abuse, mental health and other medical services as they work to provide a safe and stable home for their children are one group who is now served through this program.

Repealing the ACA without a sustainable replacement plan in place would double the number of uninsured children, and remove a vital service to one of our nations’ most vulnerable populations.

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Repeal of the ACA Would Double the Number of Uninsured Kids

One of the great success stories of the past two decades has been the increase in the number of American children who have health care coverage. We just celebrated the fact that our nation achieved the historic milestone of 95 percent of children with health care coverage.

Now Congress is considering a hasty, ill-conceived plan that would take our country on a U-turn. The number of uninsured children would double nationwide if Congressional leaders succeed in rushing forward with their risky plan to repeal the Affordable Care Act (ACA) without simultaneously replacing it. 

According to a new analysis from the Urban Institute, here in Pennsylvania, an estimated 956,000 would lose coverage - including many children, families, disabled individuals and people with pre-existing conditions such as cancer, diabetes and heart disease. 

Keeping our children healthy is key to many of the state’s goals. Asthma, diabetes, even tooth decay can keep children home from school, leaving them to fall behind academically.  Sick children can keep parents home from work, affecting their productivity. Healthy communities are prosperous communities, vital to our state's economic success.

A repeal of the ACA would also create chaos in Pennsylvania's health care system and wreak havoc on our state budget. Over a 10-year period, Pennsylvania would lose $36 billion in federal funding to meet the health needs of its residents.  Our governor and legislature already have their work cut out for them and the health care needs of Pennsylvania children and families won’t disappear when they lose their coverage.

Yet Congressional leaders tell us and our state legislators not to worry. They ask us to trust them in developing a replacement when they have been unable to agree on any such plan in the past six years. 

The stakes are too high for us to hope this time will be different. A repeal would simply pass the buck and leave Pennsylvania with a huge hole in its budget and our health care safety-net.

Voting to repeal the ACA without a replacement plan attached is not responsible governing; it’s a risky step that threatens the health of children and families.

Our elected leaders in Washington, D.C. should show responsibility and forethought by not rushing forward to repeal the ACA before they have done the hard work to negotiate and approve a replacement plan simultaneously. They owe all Pennsylvanians that much. 

To see the Urban Institute's full analysis, click here.

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National Foster Care Population Continues to Rise Says Federal Report

Last week, the Administration for Children and Families (ACF), within the Department of Health and Human Services, released new data from the Adoption and Foster Care Analysis and Reporting System (AFCARS) for fiscal year 2015. This data reflects a one-day snapshot total of youth in foster care in the United States from September 30, 2015, in addition to demographic information, type of placement and case plan goal, and entry and discharge information for children who entered and exited foster care throughout the fiscal year. 

Per the report, there were 437,910 children and youth in foster care in 2015, a 3.4 percent increase from 2014 and the third year in a row in which numbers increased from the previous year. These recent increases follow a fourteen-year period of decline. Additionally, 71 percent of states reported an increase in the numbers of children entering foster care in the past year, with the five largest reports coming from Florida, Indiana, Georgia, Arizona, and Minnesota.

ACF stated in a press release that the reason for the increase may be contributed to increased parental substance use, as removal due to parental substance use increased 13 percent from 2012 to 2015. The press release called for increased collaboration across service providers and community leaders to address this need, and noted the Children’s Bureau’s regional partnership grants program as one such program that seeks to improve the safety, permanency and well-being of children who have been removed from their homes because of parental substance abuse.

To review the data in its entirety, you can find the report here.

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National Adoption Month 2016: We Never Outgrow the Need for Family

Each November, the nation comes together to celebrate National Adoption Month, an initiative of the Children’s Bureau within the U.S. Department of Health and Human Services, Child Welfare Information Gateway and Adopt U.S. Kids. The goal of National Adoption Month is to increase national awareness and bring attention to the need for permanent families for children and youth in the U.S. foster care system. On September 30, 2015, over 111,000 children were waiting to be adopted across the nation, according to the Adoption and Foster Care Analysis and Reporting System (AFCARS).

This year, the initiative focuses on older youth adoptions, with a theme that reflects these youths' desire to be involved in conversations and decisions regarding their future: We Never Outgrow the Need for Family- Just Ask Us. To help potential adoptive parents explore the decision to adopt an older youth, engage in conversations with older youth about adoption, and build lifelong relationships with the youth in their care, the National Adoption Month website features several resources, such as tip sheets, fact sheets, videos and podcasts.

Of all Pennsylvania children and youth served in foster care in 2015, 3,962 had a permanency goal of adoption; 525 of these youth were older than 12. Since we know youth who age out of the foster care system without achieving permanency risk experiencing several poor outcomes in adulthood, securing lifelong, caring adult connections is a vital part of ensuring their future well-being.

To learn more about becoming a permanent resource for an older youth in foster care in Pennsylvania, visit adoptpakids.org. And remember, you don’t have to be perfect to be a perfect parent.

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Gov. Signs Bill Bringing PA into Compliance with Federal Child Protection Law

Act 115 was signed into law by Governor Tom Wolf today, bringing the state of Pennsylvania into compliance with the most recent changes to the federal Child Abuse Prevention and Treatment Act (CAPTA).

CAPTA, originally enacted in 1974 and most recently re-authorized in 2010, is the nation’s key federal legislation regarding child abuse and neglect. In addition to providing definitions for abuse and neglect, CAPTA provides funding for state child protective services systems. The federal law is authorized through 2016 and is up for re-authorization in the next legislative session.

Introduced by Senator Pat Vance (R), and passed unanimously in both chambers, Act 115 makes necessary changes in state law regarding parents who have committed child sexual abuse, the definition of child abuse, and the treatment of child victims of human trafficking.

Per the new law, grounds for involuntary termination of parental rights will now include instances where a parent has been found by a court to have committed sexual abuse against a child, as well as where a parent is required to register with a sex offender registry. Human trafficking is now included in the definition of child abuse, and further, the law now includes law enforcement officers who are investigating cases of human trafficking as a party to whom information from child abuse reports may be provided. 

Enacting these changes ensures that Pennsylvania is best positioned in its efforts to not only protect children from abuse and neglect, but also to provide justice to victims.

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Pennsylvania Making Great Strides in Covering Uninsured Children

The number of Pennsylvania children who are uninsured declined sharply last year as reforms began to take effect, according to a report released today. The report by Pennsylvania Partnerships for Children and Georgetown University’s Center for Children and Families found that between 2014 and 2015, the uninsured rate for Pennsylvania children declined from 5.2 percent to 4.1 percent. Before expanding Medicaid, Pennsylvania had seen only a marginal decrease in uninsured children the previous year – going from 5.4 percent in 2013 to 5.2 percent in 2014.

The 2015 data in this report does not fully capture the effects of the expansion of Medicaid because it was not in effect for the entire year. Enrollment ramped up in the first six months of 2015, and Pennsylvania will not have a full picture of the expansion’s impact until next year.

Even with the accelerated decline in uninsured children, the report shows that Pennsylvania has continued room for improvement. Only six states have more uninsured children than Pennsylvania, which means that more than 100,000 kids in the commonwealth lack basic health coverage. Pennsylvania also dropped in overall rankings of percentage of uninsured children – from 17th best in 2013 to 24th best in 2015.

Pennsylvania also has the highest rate of uninsured children of all of its neighboring states except for Ohio. The report includes data from West Virginia (2.8 percent uninsured), Maryland (3.9 percent uninsured), New Jersey (3.7 percent uninsured), New York (2.5 percent uninsured) and Ohio (4.4 percent uninsured).

Quality health coverage is essential because every child can succeed when given the chance. When it comes to setting up a child for reaching his or her potential, few things matter more than good health. When children’s health needs are met, they are better able to learn in school and parents miss fewer days of work.

Families who would like help enrolling their children should call 1-800-692-7462 or visit www.compass.state.pa.us.

 

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PA Senate Takes Step Towards School Stability for Foster Youth

One half to three quarters of youth in foster care change schools upon entering care, and one third change schools five or more times, according to research conducted by the National Legal Center for Foster Care and Education. Such educational mobility often results in lower standardized test scores, lower school grades, a greater number of missed school days and higher dropout rates for foster youth as compared to their non-foster care peers.

This week, the Senate unanimously passed Senate Bill 1271, one of three bills introduced by Senator Pat Browne (R) in an effort to minimize the educational disruption experienced by children in foster care.

SB 1271 will allow children in foster care to remain enrolled in their same school when entering foster care or experiencing a placement change, unless the court determines that remaining in the same school would be a risk to the child's safety or well-being. This determination will involve both the parents or another education decision-maker, and the child, where appropriate.

Additional legislation, Senate Bills 966 and 1272, would amend the Public School and Human Services Codes to provide guidance to school districts and child welfare agencies in regards to their responsibilities when a child in foster care faces a school change. Companion legislation has also been filed in the House: HB 1808 (Toohil-R), HB 1809 (Toohil-R), and HB 1828 (Lewis-R).

All three bills work together to implement the federal Every Students Succeeds Act (ESSA) provisions that seek to ensure school stability for youth in foster care. This week the Pennsylvania Department of Education (PDE) released recommendations from a stakeholder process they convened around the state’s implementation of ESSA. While these recommendations do not speak to the specific requirements for the school stability of foster youth as detailed in ESSA, PDE will be engaging additional stakeholders, including PPC, to focus on their enactment of these provisions through the remainder of 2016 and leading into 2017. 

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Improvements Announced Following Audit of Pennsylvania’s Child Abuse Hotline

Yesterday, the results of the Auditor General’s audit of ChildLine, the state’s child abuse hotline, were released, detailing eight findings and twenty-four recommendations. Both Auditor General Eugene DePasquale and Department of Human Services (DHS) Secretary Ted Dallas praised DHS for the improvements implemented following the interim report released in May, and Secretary Dallas promised to continue to implement changes needed to improve policy and practice.

Launched in December 2015, the audit evaluated the effectiveness of DHS’ intake process through ChildLine, and sought to determine whether calls were being processed in accordance with applicable laws, regulations and policies.

The interim report found that nearly 42,000 (43%) calls to ChildLine had been abandoned or neglected in 2015. Further, only 48% of child abuse clearances were processed on time, with an average processing time was 26 days – 12 days over the statutory requirement. The interim report was issued to allow DHS to take immediate corrective action rather than waiting until the audit was finalized.

DHS’ changes since May focused on adding staff, improving staff training, and better utilizing technology to record and monitor all calls and streamline the reporting process. These efforts resulted in 3.3% of unanswered calls in June, which further improved to under 2% in September. DHS also announced 100% of all child abuse clearance requests are now being processed on time, on average within two days.

DePasquale said Wednesday additional improvements are still needed. The most recent findings noted delayed referrals and a lack of an established training program for ChildLine caseworkers during calendar year 2015. Outcomes from child abuse and neglect investigations were also missing or submitted after the 60-day deadline, with 12,153 (10% of all reports requiring an outcome) lacking an investigation outcome. Further, auditors found that nearly 11,000 records of ChildLine reports received in 2015 were missing from their database, 352 of which were due to mis-numbering and the remainder having been deleted by caseworkers.

To learn more about the recent changes to the Child Protective Services Law, child abuse clearances and mandated reporting information, you can visit DHS’ website www.KeepKidsSafe.pa.gov. The ChildLine audit report is available online at: www.PaAuditor.gov.

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A Closer Look at PA's Latest Child Abuse Data

The Pennsylvania Department of Human Services (DHS) recently released its 2015 Annual Child Protective Services Report, which found both the total number of suspected cases of abuse and the number of substantiated reports have increased since 2014.

As PPC has noted in the past, these increases may be the result of the 24 child protection laws passed since 2013 that have increased both public awareness and the responsibilities of mandated reporters.

While the number of total suspected reports increased from 29,273 to 40,590, the rate of substantiated cases decreased from 11.4 to 10.4, potentially signaling a more vigilant Pennsylvania when it comes to child abuse and neglect.

The annual report is mandated by law to include a statistical analysis of the year’s child protective services (CPS) reports and general protective services (GPS) assessments, and seek to offer a high-level overview of the state of child abuse and neglect in the commonwealth. Last year was the first full year in which all CPS and GPS reports and assessments were received and maintained at ChildLine, rather than being processed in two separate databases –  a change designed to streamline the process of identifying perpetrators of child abuse seeking to work or volunteer in positions that require direct contact with children.

Over one million individuals requested child abuse clearances in 2015, and ChildLine identified 1,828 as on file as perpetrators of abuse. Further, 497,285 Pennsylvanians were trained in child abuse recognition and reporting by the three DHS contracted vendors in 2015 alone.

The latest bill designed to improve child protection in the state, Senate Bill 1156, is currently pending in the Senate Rules and Executive Nominations Committee. It would require health care personnel and clergy who are responsible for a child’s welfare or have direct contact with children to obtain background checks, and would extend the time valid GPS reports can be kept in the statewide database.

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The Importance of Developmental Screenings

A child’s first years of life are marked by tremendous growth both physically and mentally, and detecting possible delays in development during these early years is a critical part of ensuring every child gets off to the best possible start and is well prepared to learn and grow up healthy.

About 1 in 10 Pennsylvania children may experience a delay in one or more aspects of development, but Pennsylvania lacks a comprehensive way of monitoring how many children receive developmental screenings that could help detect these delays.

Our latest report – Developmental Screening: An Early Start to Good Health – looks at ways Pennsylvania can better promote the use of developmental screenings, educate families about their importance and ensure children with possible delays in development receive appropriate follow-up assessments, care and interventions.

Increasing the use of developmental screenings not only helps ensure healthy outcomes for our children, it also can bring a strong return on investment. One study found well-designed early childhood interventions can generate a return to society ranging from $1.80 to $17.07 for each dollar spent on the program.

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