[NYAPRS Enews] Report: Bush-era Medicaid Policies on Children's MH Continue Despite Obama Rollback

[Matt Canuteson]

New Report Finds Bush-era Medicaid Policies on Children's Mental Health
Continue Despite Obama's Rollback; Children Lose Access to Vital Mental
Health Care as Restrictions on Therapeutic Programs Continue

Alliance for Children and Families September 2, 2009

 

WASHINGTON, D.C. - States have continued to implement Bush-era Medicaid
policies on children's mental health despite a decision by the Obama
administration to reverse those policies, according to a new report
released today by the Alliance for Children and Families, a coalition of
nonprofit health care providers for children in the child welfare
system.  The Alliance estimates that left unaddressed, the ongoing
implementation of the Bush policies could reduce needed mental health
care for tens of thousands of children across the nation.

 

The report found that states are continuing to implement Bush
administration policies that limited funding for mental health services
for foster children with serious emotional disturbances.  These
services, including therapeutic foster care (TFC), are covered by
Medicaid in most states. 

 

The Bush administration began restricting these services in some states
in 2003 and continued the restrictions throughout the 2000s, even after
Congress blocked their implementation.  When President Obama entered
office, he rolled back regulations limiting these Medicaid services.
However, due to a combination of state momentum and incomplete reversals
of the Bush policies by the Centers for Medicare and Medicaid Services
(CMS), their implementation has continued.  

 

Nonprofit child welfare providers report that the continuation of the
Bush-era restrictions has resulted in serious harm to foster children
and to state child welfare systems.  Normer Adams, Executive Director of
the Georgia Association of Homes and Services for Children, described
the implementation of the policies in Georgia as "like a bomb was set
off in our child welfare system."  

 

In Colorado, "our state system is crippled right now.  It is in fiscal
crisis," stated Dr. Skip Barber, Executive Director of the Colorado
Association of Family and Children's Agencies. 

 

Ongoing implementation of the Bush policies has also resulted in poorer
health outcomes for children and increases in community violence.  "The
continuation of these Bush Medicaid policies is harming vulnerable
children's health," said Patrick Lester, Senior Vice President of Public
Policy for the Alliance.  "We understand that policy changes take time
for any new administration to implement, but it is far past time for CMS
to act."

 

The report compiled information on nineteen states from 2003 to the
present.  During this period, twelve of the states had implemented the
Bush policies or had begun doing so, even after Congress passed a law in
2007 blocking the restrictions from taking effect.  States report that
without a clear reversal of policy from CMS, they feel compelled to
continue with the changes or risk being found to be out of compliance
with federal Medicaid law.  The result has been widespread funding cuts
to therapeutic services.

 

The report describes several policy options for CMS and Congress to halt
the ongoing implementation of the Bush policies.  These include written
guidance from CMS approving therapeutic foster care as a
Medicaid-reimbursable service, which would give states immediate relief
from the Bush policies.  To permanently ensure states' ability to cover
such services, Congress could consider including them in health reform
as Medicaid-reimbursable services.  Congress may also opt to enact the
Medicaid Services Restoration Act (S. 1217), which creates a new
category of Medicaid funding for therapeutic foster care and expressly
permits states to use "reasonable" payment methodologies (including
daily bundled payments) for rehabilitative services.

 

The full report is available online at:

http://www.alliance1.org/Public_Policy/Health/Bush_era.pdf

 

# # #

 

The Alliance for Children and Families, a nonprofit association, was
formed by the 1998 merger of Family Service America and the National
Association of Homes and Services for Children. The Alliance represents
over 370 nonprofit organizations across the nation that provide services
and economic empowerment to children and families. Alliance agencies
cover a wide spectrum of providers, including a diversity of faith-based
organizations and nonsectarian agencies. Together, these organizations
deliver more than $2 billion annually in services to more than 8 million
people in nearly 6,700 communities across the United States. More
information about the Alliance is available at www.alliance1.org
<http://www.alliance1.org/> .  

 

United Neighborhood Centers of America (UNCA) is a voluntary, nonprofit,
national organization with neighborhood-based member agencies throughout
the United States. Formerly known as the National Federation of
Settlements and Neighborhood Centers, it was founded in 1911 by Jane
Addams and other pioneers of the settlement movement. More information
about UNCA is available at www.unca.org <http://www.unca.org/> .

 

For more information, contact the Washington office of the Alliance and
UNCA at:

 

Alliance for Children and Families / United Neighborhood Centers of
America

1001 Connecticut Ave., NW, Suite 601

Washington, DC 20036

(202) 429-0400

policy at alliance1.org

 

 

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