Thursday, December 13, 2007

Leaving our most vulnerable children behind

How to write when the rage is boiling? I don't know, but I'll try. There is some news out this week that will drastically affect child welfare all over this country in the next few months because of decisions our Congress made almost two years ago. But I can't find a word about it in the Washington Post, the New York Times or the Los Angeles Times. Granted, to understand how this happened and how children will be affected takes some time to explain. But still...

If you'll bear with me for a moment, I'll tell you what happened.

Back in January 2005, Congress passed and Bush signed a budget reconciliation bill. I don't know if any of you remember that bill, but it included cuts in funding to programs like student loans, child support and other safety net services. These cuts were needed in order to continue to grant the wealthy in this country additional tax cuts.

A somewhat obscure cut was made in Medicaid to a program called Targeted Case Management. This funding, which must be matched by local jurisdictions, has been used all over the country to pay for services to our most vulnerable populations: victims of child abuse, the mentally ill and retarded adults.

So, you might ask why I'm writing now about cuts made back in 2005. Good question. Because it has taken this long for the feds to issue a ruling on how this cut will be administered. Just last week the ruling was issued to take effect March 4th. Each state uses this funding differently, so you might need to check in locally to determine what will be the effect in your area. According to an article in the Star Tribune,

The rule apparently will cut about $50 million in federal Medicaid money for an innovative service that helps 70,000 troubled, abused or foster children and their families in Minnesota.
Here is how the article describes the "innovative service" that will be eliminated with these cuts:

The service is called targeted case management, which has been used by counties to revamp a cumbersome social service system in which people with multiple problems often had to deal individually with myriad complex public and private agencies.

In targeted case management, social workers may assess needs for the whole family, develop a comprehensive plan and then coordinate medical and psychological help, housing, jobs, education, parenting help and other services.
All that might sound like shop-talk to some, so let me tell you a story about a young man, we'll call him Drew, whose family has been served through the use of Targeted Case Management Funds:

Drew lives with his maternal grandmother, mother, and three sisters. He and his three sisters have three different fathers - none of whom is involved. His mother is extremely ill, having only one kidney and that one is in failure. She has dialysis three times a week.

Drew came to the attention of authorities when he was 8 years old and his mother took the children to an emergency room because it was mid-November and they had been homeless for 3 months. Prior to that time, they had moved at least 10 times in Drew’s 8 years - many times across state lines. This started a process of the children being placed in and out of temporary shelter programs over the next few years as mom continued to go in and out of various forms of housing.

There are also many reports in the system of domestic violence by various men with whom the family was housed. Sometimes this was men mom was involved with and other times, friends they were staying with. But, even more serious, over the years, all four children were sexually abused, and its still unclear who the various perpetrators were. What we know is that Drew, by the time he was 10, was regularly acting out sexually.

But we got involved with Drew because, by the time he was 10, he had already been written up by the police 4 times for assualt. One was against a teacher, two against staff in the shelter where he lived, and one against another boy. Anyone want to wonder where Drew was headed with all of this??

We have been involved in Drew’s life now for over 6 years. During that time, our staff have worked to help the family find stable housing, facilitate therapy for mom and all the kids about the sexual abuse, get Drew a psychiatric assessment and medication management, connect Drew with an adult mentor, facilitate conferences and planning with his school to make sure his needs are met and on and on the story goes.

This week, Drew stopped by our office on his lunch break from his internship with the City Attorney's Office to visit with his caseworker. There he was, 16 years old and absolutely beautiful!!! All dressed up for work with his shirt and tie. Big smile for everyone and proud of himself. He’s talking about wanting to be a lawyer as a result of his work in the City Attorney’s Office.
My rage today comes from thinking about all the other Drews in my community who will be left to fend for themselves through these kinds of devastating cirumstances - just so Bush and friends could get their tax cuts. But there might be something you can do to at least stall this kind of thing from happening. First of all, search your local newspapers to see if they're reporting on this rule and see if you can find out how it will affect children in your community. And then make some calls. Here's what the Star Tribune article says at the end:

In an attempt to blunt the effect of the new rule, a bill sponsored by Minnesota's U.S. senators would delay implementation for six months. So far, it hasn't gained traction.
I imagine the thinking is that if we can delay implementation for six months, some new legislation could be crafted with the potential for bi-partisan support (the MN Senators referred to are Republican Norm Coleman and Democrat Amy Klobuchar) to undo these draconian cuts to services for our most vulnerable children. I'm thinking that a call to your Senator to ask them to join with Coleman and Klobuchar to delay this rule would be helpful to children in your state too. So I'm asking you to make that call. Thanks.

Update
Our local St. Paul Pioneer Press has more information on the work to stall this rule in this article MN lawmakers fight rule that would cut millions for at risk kids.

Minnesota lawmakers say they will push legislation to head off a new federal Medicaid rule that would cut into a program aimed at helping abused and neglected kids and others, which could cost the state tens of millions of dollars in aid.

Republican Sen. Norm Coleman and Democratic Rep. Keith Ellison have authored bills that would require the U.S. Department of Health and Human Services to allow for 180 days of public comment before coming up with a final rule.

According to Coleman's office, the rule could lead to cuts of $45 million a year for Minnesota programs that help protect children in foster care, and as much as $38 million a year for programs for elderly and the mentally ill.

Although the department has already issued the rule, it won't be effective for another 90 days, and the lawmakers are hoping to get their bills passed before then. In a statement Tuesday, Coleman said he was working with members of the Senate Finance Committee to get movement on the bill.

"However, if we are unable to get this legislation passed before the rule is finalized in March, I will continue to seek a legislative fix to modify this rule and mitigate the effects it will have on vulnerable Medicaid beneficiaries," he said.

Ellison's legislative director, Minh Ta, had a similar strategy, saying if the bill doesn't get through, "We'll deal with this issue one way or another." He did say it was unlikely that the House would take up the bill before the end of the year.

You gotta believe that if Norm Coleman and Keith Ellison can come together to work on something like this - it just might be possible.

Here are the members of the Senate Finance Committee that Coleman referred to:

Max Baucus, Chairman Montana
Jay Rockefeller West Virginia
Kent Conrad North Dakota
Jeff Bingaman New Mexico
John Kerry Massachusetts
Blanche Lincoln Arkansas
Ron Wyden Oregon
Charles Schumer New York
Debbie Stabenow Michigan
Maria Cantwell Washington
Ken Salazar Colorado
Chuck Grassley, Ranking Member Iowa
Orrin Hatch Utah
Trent Lott Mississippi
Olympia Snowe Maine
Jon Kyl Arizona
Gordon Smith Oregon
Jim Bunning Kentucky
Mike Crapo Idaho
Pat Roberts Kansas
John Ensign Nevada

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