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Isabella Brooke Knightly and Austin Gamez-Knightly

Isabella Brooke Knightly and Austin Gamez-Knightly
In Memory of my Loving Husband, William F. Knightly Jr. Murdered by ILLEGAL Palliative Care at a Nashua, NH Hospital

Saturday, September 24, 2011

Tell Your Senator's NO on S.1542

Child and Family Services Improvement and Innovation Act

Another bill (H.R. 2883/S. 1542), reauthorizing Title IV-B of the Social Security Act,
was introduced in both the House of Representatives and Senate on Monday, September
12. It passed the House Ways and Means Committee on Wednesday, September 14, the
Senate Finance Committee on Tuesday, September 20, and the full House Wednesday,
September 21. Similar to H.R. 2790—recently introduced and passed in the House—this
bill reauthorizes and makes some changes to IV-B Part 1, Child Welfare Services (CWS)
and Part II, Promoting Safe and Stable Families (PSSF) through 2016. Additionally, it
includes a second title which reinstates Social Security Act, Title IV-E waiver authority.
CWS is a discretionary program providing flexible formula funding for a broad range of
services designed to support, preserve, and/or reunite children and their families. H.R.
2883/S. 1542 maintains its authorization level at $325 million. CWS requires each state
to create a child welfare services plan—which encompasses case reviews and
permanency planning, program development, agency administration, and systems
collaboration activities. S. 1542/H.R. 2883 adds the following additional requirements:
• Adds to the state plan provision for ongoing oversight and coordination of health
care services the explicit requirement to outline how emotional trauma needs
associated with a child’s maltreatment and removal identified through initial and
follow-up health screenings will be monitored and treated.
• Also, adds to the state plan provision for ongoing oversight and coordination of
health care services the explicit requirement to include protocols for the
appropriate use and monitoring of psychotropic medications in the oversight of
prescription medicines.
• Adds a new state plan provision requiring the inclusion of a description of state
activities aimed at reducing the length of time children under age 5 are without a
permanent family and state activities addressing the developmental needs of
children under age 5 who are served by both IV-B and IV-E of the Social Security
Act. • Adds a new state plan provision requiring the inclusion of a description of the
sources of child maltreatment death information. This provision specifically refers
to a list of possible sources and includes a requirement for states to incorporate an
explanation if they do not have information from those sources. [NEW: This
provision on child death sources was not included in H.R. 2790]
The bill also revises the caseworker visit requirement in CWS. It was previously a goal to
have 90% of children in care visited by their caseworker monthly—with a majority of
those visits occurring in the child’s residence— by October 1, 2008. H.R. 2883/S. 1542
maintains the 90% goal, as well as a tiered federal financial participation reduction for
failure to comply, but it requires only that the total visits in a year to equal the amount of
visits if a child were visited monthly. In addition, the tiered reduction for failure to
comply is added for a new goal of 50% of caseworker visits occurring in the child’s
residence. A corresponding amendment is made in Title IV-E to update data collection on
this modified visit requirement. [NEW: The IV-E update was not included in H.R. 2790]
PSSF targets formula funding to four categories of services; family support, family
preservation, time-limited family reunification, and adoption promotion and support. In
addition, it includes reserved funding and additional authorizations for courts; substance
abuse grants; caseworker visits; tribes; mentoring; and research, evaluation, and technical
assistance. PSSF funding is both mandatory and discretionary. H.R. 2883/S. 1542 reduces
the mandatory funding from $365 million to $345 million and maintains the authorization
of $200 million in discretionary funding. [NEW: Unlike H.R. 2790, the reduction in this
bill is not taken from the reservation of funds for the Court Improvement Program.]
PSSF includes a section listing requirements for state plans to fulfill PSSF provisions.
The PSSF state plan encompasses goal setting for services, a review process,
coordination of services, and child safety assurances. H.R. 2883/S. 1542 adds a
requirement for states to identify populations most at risk of maltreatment and describe
how services are targeted to those populations. [NEW: This provision was not included in
H.R. 2790]
Within the section of PSSF defining various terms used within the legislation, the
definition of “family support services” —one of the four categories of services— is
amended by clarifying that enhancing child development, one of the listed aims of family
support, can be accomplished through mentoring. Also, under the definition for “timelimited family reunification services” — another of the four categories of service— new
examples of services and activities are added, including peer-to-peer mentoring, support
groups for caregivers and services and activities designed to facilitate parent and sibling
visitation with children in care. Finally, the definitions for “Indian Tribe” and “Tribal
Organization” are updated to be consistent with the way they are defined in the Indian
Self-Determination and Education Assistance Act (25 U.S.C. 450b). [NEW: None of
these amended definitions were included in H.R. 2790] H.R. 2883/S. 1542 also amends the PSSF annual report—comprised of each state’s
service expenditures and required of the Department of Health and Human Services
(HHS) to send to Congress (i.e., House Committee on Ways and Means and Senate
Committee on Finance)—to include actual spending in addition to planned spending by
service category for the program. Furthermore, the bill requires that this report be posted
publically on HHS’s website. Additionally, the bill requires the Government
Accountability Office (GAO) to submit a report within a year of the bill’s enactment that
identifies alternative federal funding sources for IV-B activities and services and assesses
the needs of families eligible for these services, caseworkers’ resources to safely manage
caseloads, the number of families and length of time they wait for substance abuse and
other preventive services, and the effect of the delay of those services on reunification.
[NEW: The GAO report was not included in H.R. 2790]
Two additional PSSF grants for targeted purposes—to support monthly caseworker visits
and regional partnership grants to address permanency affected by parental substance
abuse—are both maintained at $20 million allotments each. The purpose of the monthly
caseworker visit allotment is amended to specify that improving caseworker decisionmaking is in regards to decisions made about the safety, permanence and well-being of
children in care. [NEW: This amended purpose was not in H.R. 2790] Within the
discretionary grants targeting substance abuse, the bill removes the language giving
greater weight to applicants addressing methamphetamine abuse specifically. The bill
also adds that extensions of substance abuse grants are limited to two years, but that
multiple grants are allowed, and the varying limit of the federal share of the cost of
services under the grant is updated through seven fiscal years. It also adds a 5 % limit on
HHS administrative expenses for this grant program [NEW: The details of grant
extensions, federal shares, and administrative limits were not in H.R. 2790] Finally, the
bill also requires an HHS evaluation of the programs and activities provided under the
substance abuse grants from FY2007 through 2011 and again from FY2012 through
2016. HHS reports on these evaluations are due December 31, 2012 and 2017,
respectively. [NEW: This evaluation was not included in H.R. 2790]
PSSF sets aside mandatory and discretionary funding for grants for highest state courts
that carry out child welfare activities. H.R. 2883/S. 1542 adds a clarification that court
grant improvement plans should include requirements related to concurrent planning.
Furthermore, the bill adds a requirement that these plans, as well as legal personnel
training, should seek to improve family engagement in all stages of permanence in court
processes. The bill also streamlines the number of necessary applications to one,
regardless of the number of purposes the highest state court applying for funds plans to
address. Finally, the bill divides the court improvement grants into funding categories by
purpose of the grant and assigns each category a monetary reservation— $9 million for
assessing court systems and implementing improvements, $10 million for improving
permanence and timeliness of placements, $10 million for training court and legal
personnel, and $1 million for tribal courts. The bill also specifies that any discretionary
funding allocations for court improvement should go to the first funding category of
assessing court systems and implementing improvements. [NEW: The family engagement provision, streamlined application requirements, and funding categories were
not included in H.R. 2790]
H.R. 2883/S. 1542 makes a few additional changes to child welfare legislation. It adds a
part III to title IV-B, titled, “Common Provisions.” This subpart is comprised of a section
on “Data Standardization for Improved Data Matching.” This calls on HHS to work with
the Office of Management and Budget (OMB) to designate standard data elements for
any category of information required to be reported in IV-B. Additionally, under IV-E of
the Social Security Act, the bill clarifies that the requirement for educational stability for
children in care refers to “each” placement, removing confusion about the requirements
applicability beyond the first placement. Also in IV-E, the bill requires states to
document savings from the de-link of adoption assistance payments from the old Aid to
Families with Dependent Children eligibility that is part of the 2008 Fostering
Connections legislation. Also in IV-E, under the definitions section, “case review
system” is amended with an additional responsibility of the state to obtain a copy of a
consumer report yearly for all children in care over the age of 16. Furthermore, the bill
requires that the youth receives assistance in interpreting and resolving inaccuracies,
where possible, by a court-appointed advocate. [NEW: The consumer report provision
was not included in H.R. 2790]
H.R. 2883/S. 1542 fails to reauthorize the discretionary Mentoring Children of Prisoners
grants. This program was zeroed out in the FY 2011 appropriations. [NEW: H.R. 2790
reauthorized this program at $25 million each year through 2016.] Also, the bill does not
require HHS to study the state of recruiting and supporting foster parents, adoptive
parents, and kin caregivers. [NEW: This study was included in H.R. 2790]
Finally, H.R. 2883/S. 1542 reinstates waiver authority for Title IV-E demonstration
projects. [NEW: Waivers were not included in H.R. 2790] Waivers are legislatively
authorized and administratively approved interruptions of federal regulation to allow
states more flexible use of a particular funding stream. This bill aims to bridge the
differences between the two chambers’ approaches at IV-E waiver reauthorization. It
cedes to the House on some points including the duration of the demonstration projects
the bill authorizes, while yielding to the Senate by including language requiring states to
undertake specific efforts to improve permanency and outcomes and prevent abuse and
neglect in order to be eligible for a waiver.
The bill allows HHS to issue up to 10 waivers each year from 2012 through 2014.
Waivers cannot exceed five years or end after 2019. To qualify, a state must increase
permanence by reducing time in foster care, increase positive outcomes for children and
families, or prevent maltreatment and re-entry into care. In addition the state must have or
plan to implement at least two of the following policies: establishing a bill of rights for
children in care, implementing a health and mental health plan for children in care,
covering kinship/subsidized guardianship with IV-E funding, extending IV-E foster care
to 21, implementing a plan to reduce congregate care, increasing the placement of
siblings together, implementing a plan to improve the recruitment and retention of quality foster families, establishing procedures to assist youth in transitioning out of care, state
plan inclusion of older youth guidance in their own transition plan, and the establishment
of one or more programs to prevent placement in care and provide permanency.
Furthermore, the bill includes reporting requirements that must start two years prior to the
waiver application, account for all child welfare spending during the time of the waiver,
provide periodic reports, and obtain an independent evaluation. Finally, tribes are eligible
to apply for waivers if they are running a IV-E plan.

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