On Tuesday the President released his budget for FY 2015. Under budget law the request is to be released in early February, but the fact that Congress has not been able to enact a final appropriation by the start of the fiscal year on October 1 or by the end of the calendar year, February budget releases appear to be a practice of the past. The budget agreement (P.L. 113-67) that replaced the sequestration for two years has also established joint budget ceilings for FY 2015. As a result the Senate will not pass a budget resolution for this year and instead start the appropriations process without that resolution.
Overall the President proposes similar requests to last year’s 2014 budget.
- Within child welfare the most significant proposed change is a new proposal that if enacted, would create a joint effort by Administration for Children and Families (ACF) and the Centers for Medicare & Medicaid Services (CMS) to improve treatment for children in foster care, particularly in regard to the over-use of psychotropic medication.
- Generally the remaining child welfare services are at levels last established in the January agreement in the FY 2014 appropriation (P.L. 113-46). Funding for the critical Administration on Children and Families (ACF) is proposed at a total budget of $51 billion a slight increase of $157 million. Only $17 billion of this total is discretionary (annually appropriated) which is actually a decrease of $637 million from FY 2014.
- Other noteworthy child welfare related proposals include the Administration’s request to restore the Social Services Block Grant (SSBG), to address sex trafficking and to fund a couple of research studies.
- One of the more significant proposals is a continuation of his proposed expansion of early childhood education, including the extension of home visiting funding that is due for reauthorization this year.
The Administration is requesting funding for a joint project by ACF and CMS to address the over use of psychotropic medications by promoting evidenced-based interventions targeting children in the foster care system. The budget includes, for each of the next five years, $50 million available through ACF along with an additional $100 million a year through Medicaid.
Many of the specifics are still to be worked out, but the funding awarded through ACF would help build capacity by enhancing child welfare workforce; providing reliable screening and assessment tools; coordination between child welfare and Medicaid especially Early and Periodic, Screening, Diagnosis, and Treatment (EPSDT); training for foster parents, adoptive parents, guardians, and judges; implementing evaluation tools and providing data. At the same time CMS would provide incentive grants to state Medicaid agencies if they could achieve certain targets and goals regarding services to children in foster care and similar children. The goal is to enhance services that would not just reduce the over use of psychotropic medications for children in foster care but also enhance the therapies and services to children and families in this population.
It has the potential to improve services for a population of children and families beyond foster care placements. ACF NSCAW data show that 18 percent of the approximately 400,000 children in foster care were taking one or more psychotropic medications at the time they were surveyed. GAO has estimated an even higher range of 21 to 39 percent. Children in foster care are prescribed psychotropic medications at far higher rates than other children served by Medicaid, and often in amounts that exceed the Food and Drug Administration’s guidelines.
Most other child welfare services programs remain at FY 2014 levels. The biggest funders, Title IV-E foster care, adoption assistance and kinship care are awarded funding based on the number of children eligible. Funding for Child Welfare Services (CWS), Promoting Safe and Stable Families (PSSF) remain at 2014 levels which ended up being somewhere between the cuts imposed by the recent sequestration cuts and what the programs were awarded in pre-sequestration 2011. As a result several of these child welfare programs continue to lose funding. In addition to these programs, child protection and prevention programs also were requested at 2014 levels. The CAPTA state grants and the Community-Based Child Abuse Prevention (CB-CAP) funds are all at the 2014 levels and slightly lower than 2011.
The Administration is once again proposing that Congress reauthorize the Family Connections Grants at $15 million a year through 2016. The mandatory funds are used to seed programs that set up kinship navigator, family finding, family group decision making and residential substance abuse treatment. The funding actually expired on October 1 and Congress has not been able to extend the funding as it has been tied up in a bigger piece of child welfare legislation. In October, the House passed HR 3205, the Promoting Adoption and Legal Guardianship for Children in Foster Care Act, which extended both the adoption incentive program and the Family Connections Grants but the Senate failed to act on its own version of a bill and as a result the “offset” (savings found in the budget to cover the cost of an extension) was lost as it was used in the budget agreement. Now Congress must find a new offset or funding to extend the program.
Other significant child welfare related proposals include the Administration’s request to restore SSBG to its pre-sequestration level of $1.7 billion. The Administration is also seeking to increase to $10 million funds to address domestic sex trafficking through the Office of Refugee Assistance. In January an initial $1.7 million was provided for competitive grants to address domestic commercial sexual exploitation. How this initial funding is awarded is still being developed. The Administration is also proposing $6 million for the National Survey of Child and Adolescent Well-Being (NSCAW) that have examined child and family well-being outcomes in detail from 1997 through 2013. The research relates experiences with the child welfare system and to family characteristics, community environment, and other factors. The most recent brief based on the research, report No. 19: is “Risk of Long-term Foster Care” was released last September. In addition to the child welfare study the Administration is seeking $2 million on the Prevalence, Needs and Characteristics of Homeless Youth. That study is included under the Runaway and Homeless Youth Act.
The President re-submitted his vision for expanded prekindergarten (Pre-K) and early childhood education. The 2014 appropriations deal provided some initial seed funding of $250 million. There would be $1.3 billion in matching federal funds for states that already have programs with funds to be used to expand the quality and availability of current services. Generally the early target populations are families at 200 percent of poverty and below although a larger population would be served. States would have to meet rigorous standards beyond what they have been required to provide under the current child care system of block grants. The pre-k portion would be funded by increasing the current tobacco tax—the same as last year.
In addition to the pre-k funding the Administration proposes to extend the current home visitation program now funded under Title V, the Maternal and Child Health Block Grant. The program is set to expire after FY 2014 and the President proposes to extend it starting in FY 2015 for another ten years with funding set at $500 million in FY 2015. A fourth important component is the expansion of Early Head Start. Early Head Start would receive $650 million in FY 2015 an increase of $150 million within the Head Start program. As proposed last year, this expansion would link Early Head Start to center and family based care seeking to significantly improve the quality of services provided. The Administration would add $120 million to the Head Start program to continue current initiatives to improve the quality of current Head Start programs. Total funding for Head Start (includes both Early Head Start and Head Start) would increase from $8.598 billion in FY 2014 to $8.868 billion in FY 2015.