Transcript FEDERAL UPDATE MASSACHUSETTS ICC RETREAT SEPTEMBER …

F EDERAL U PDATE
M ASSACHUSETTS ICC RETREAT
S EPTEMBER 23, 2009
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S TATE F ISCAL R EALITY
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At least 27 states have implemented cuts that will
restrict low-income children’s or families’ eligibility
for health insurance or reduce their access to
health care services
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At least 24 states plus DC are cutting medical,
rehabilitative, home care, or other services
needed by low-income people who are elderly or
have disabilities, or significantly increasing the cost
of these services
September 2009
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C ENTER FOR B UDGET P OLICY
P RIORITIES – WWW. CPBB . ORG
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At least 25 states are cutting aid to K-12 schools
and early education programs
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At least 34 states have cut assistance to public
colleges and universities, resulting in reduction
in faculty and staff in addition to tuition increases
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At least 42 states and the District of Columbia
have made cuts affecting state government
employees
September 2009
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L EAD A GENCIES N EED SICC S UPPORT
AND PARTNERSHIP M ORE T HAN E VER
Challenge to maintain
an appropriate
balance between
quality and
compliance in context
of major fiscal crisis
U PDATE TOPICS
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Early Childhood Initiative
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Healthcare Reform
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ARRA Funds
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Congressional Activities
E ARLY C HILDHOOD I NITIATIVE
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C AMPAIGN P OLICY P OSITION
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Expand and Improve Head Start
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Expand/create regional training centers
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Upgrade teacher compensation and qualifications
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Create career lattice
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Seamless system of quality control
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Fund research to develop programs that serve as
a stepping stone to universal preschool
C AMPAIGN P OLICY P OSITION
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Expand scope of early childhood to start at birth
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Nurse Family Partnership for all first time
mothers
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Expand Early Head Start from 60,000 to 240,000
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Expand research and program development in
the area of infant and early childhood brain
development
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Expansion and integration of Part C into early
childhood efforts
Early Learning
Challenge Fund
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New Early Childhood appointments in U.S.
Departments of Education and HHS
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Early Learning Challenge Fund passed by House
September 17th by a vote of 253-171
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Included as Title IV of H.R. 3221 The Student Aid and
Fiscal Responsibility Act
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Bill expected in the Senate this Fall
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Program will be Jointly administered by Education
and HHS
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Authorized at $8 Billion for 8 Years
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P URPOSES
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To promote standards reform of State programs
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To establish high standard of quality in programs
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To fund & implement quality initiatives that improve skills
and effectiveness of providers, & improve quality of
existing programs,
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To ensure a greater number of disadvantaged children
enter kindergarten with cognitive, social, emotional, and
physical skills and abilities to be successful in school.
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To increase parents' abilities to access comprehensive and
high quality early learning programs .
Competitive State
Grants
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Includes 2 different state competitive grants for
Birth to Five
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Quality Pathways Grants – up to 5 years
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Development Grants – up to 3 years
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State lead agency established by State
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Must coordinate proposed activities with the State
Advisory Council on Early Childhood Education and
Care
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Must coordinate with Title 1, Head Start, Child Care,
Part C and 619 of IDEA
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Part C Assurance
States applying for a Quality
Pathways Grant must include an
assurance that the State will
continue to participate in Part C
of the IDEA for the duration of
the grant.
H EALTHCARE R EFORM
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P RESIDENT ’ S P RINCIPLES
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S EPTEMBER 9 , 2 0 0 9
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More Stability and Security
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End barriers to coverage with pre-existing medical
condition
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Limit premium discrimination based on gender and age
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Prevent insurance rescission
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Cap out of pocket expenses
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Eliminate extra charges for preventive care
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Protect Medicare for seniors
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Eliminate “donut hole” gap in prescription drugs
P RESIDENT ’ S P RINCIPLES
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S EPTEMBER 9 , 2 0 0 9
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Assure affordable, quality health coverage for all
Americans
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Create insurance marketplace – The Exchange
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Tax credits to individuals and families to help
purchase of insurance
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Small business tax credits
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Public health insurance option
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High risk pool until Exchange is created
P RESIDENT ’ S P RINCIPLES
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S EPTEMBER 9 , 2 0 0 9
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Rein in the Costs of Health Care
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No addition to deficit
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Requires additional cuts if savings not realized
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Implements delivery system reforms that address costs
and incentives to improve quality
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Commission to identify waste, fraud and abuse
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Medical malpractice reform projects
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Requires large employers to cover employees
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Requires individuals to buy insurance
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Hardship exemption
H EALTH C ARE R EFORM
P ROCESS
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Senate Finance Committee mark-up is this week
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564 Proposed Amendments
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Baucus bill – Gang of 6 - released 9/17 ($856B)
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Next step for the Senate –merge HELP and
Finance bills
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House working this week to merge three versions
of the bill
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President’s Speech Before Congress 9/9/09
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Major reaction/concern by all sides
B AUCUS B ILL
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Creates a minimum health care benefit package
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Requires citizens and legal residents to have health insurance
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Some exemptions will be granted
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Premium credits
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Imposes tax on individuals who do not get coverage
Requires businesses with more than 50 employees to
provide insurance coverage
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Requires businesses with more than 200 employees to
automatically enroll them in insurance plans
Temporary high risk Insurance pools until new insurance
market rules are in effect
B AUCUS B ILL
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Expand Medicaid to all individuals with incomes up to
133% of poverty
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In 2013, expand CHIP eligibility to 250% FPL and enroll
them in Exchange programs
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Adults between 100-133% FPL have option of Medicaid or
federal subsidies through the Exchange
Requires states to cover services not included in Exchange
plans including EPSDT services as wrap- around benefits
Contains supportive MCH language
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Includes $1.5 B for early childhood home visiting programs
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Additional needs assessment requirements
U SE OF ARRA F UNDS
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G UIDING P RINCIPLES
Spend Quickly to Save and
Create Jobs
Ensure Transparency and
Accountability
Thoughtfully Invest OneTime Funds
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S TATES N EED TO BE “S HOVEL
R EADY ” AND AVOID “ CLIFF ”
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U.S. E DUCATION S ECRETARY
D UNCAN TO G OVERNORS
“Our role is to be a partner and a
resource to you as you work to balance
your budget…while advancing these
essential reforms in our nation’s schools
so that every child in America can receive
a complete and competitive education –
from cradle through career.”
R EMEMBER :
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
Part C received an extra $500 million
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MD and NM accessed the optional
Part C Birth-kindergarten funds
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ARRA funds are treated like all other
IDEA funds:
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Same Funding Formula;
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Same Maintenance of Effort; and
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Same Use of Funds.
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U SE OF ARRA F UNDS – A LL S TATES
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U SE OF ARRA F UNDS – H EALTH L EAD
A GENCIES
Direct Services
8%
18%
6%
Personnel Training
Development of Web Modules
2%
Recruitment and retention
3%
Utilization Review
Cost/Rate Study
12%
14%
Practice Guidelines
Translation/Printing Publications
Family Support
Data Systems
5%
Enhanced Montoring Systems
10%
6%
Child Family Outcomes
Policies/Procedures/Regulations
5%
4% 2% 5%
Regional Local System Enhancement
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U SE OF ARRA F UNDS – NERRC
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C OMPARISON A CROSS C ATEGORIES
O THER C ONGRESSIONAL A CTIVITIES
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Funding for FFY’10
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FFY’10 begins Oct 1 and none of the 12 bills are
completed - FFY’10 are for July 2010 awards
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Continuing Resolution will be necessary
probably at current FFY’09 levels
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Senator Harkin (IA) and Roberts (KS) introduced
Part B Full Funding Bill -S. 1652
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House Part B full funding bill - H.R.3578 by Van
Hollen (MD), Platts (PA) and Walz (MN)
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Advocacy now for FFY’11 with Administration
111 th Congress
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
Senator Harkin (IA) has become Chair of Senate
HELP Committee
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1st Session likely will work until at least
Thanksgiving
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2nd session to begin in January 2010
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November 2010 – Mid-term election of the
112th Congress
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January 2011 – 112th Congress Convenes
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111th Congress
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SCHIP Reauthorization – Completed
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Child Care Block Grant Reauthorization
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CAPTA Reauthorization
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Developmental Disabilities Act
Reauthorization
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SAMPSA Reauthorization
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Child Nutrition
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Ryan White Reauthorization
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Institute on Education Sciences Reauthorization
More for the 111 th Congress
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Seclusion and Restraint - Hearings, Data
Collection, Letter from Secretary and Possible
Legislation
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Bullying – H.R. 2262 – Safe Schools
Improvement Act
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Elementary and Secondary Education Act (ESEA)
– Secretary Duncan is beginning a series of
meetings this week and planning forums to
discuss ESEA proposals
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IDEA Reauthorization
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