Children and Youth Initiatives Entangled in Health Care Uncertainty

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Abstinence education, teen pregnancy prevention, family visitation and health care for foster kids – these are just a few of the youth field’s favored things that might be in jeopardy if health care legislation goes down in the wake of this month’s Senate election in Massachusetts.

“There really are some good programs” that “I do fear” could be lost, said Lisa Guernsey, director of New America Foundation’s Early Education Initiative.

Lost, that is, if Congress can’t reach final agreement on sweeping health care legislation or if bills are stripped down to their essentials, as a result of the Democrats losing their 60-seat, filibuster-proof Senate supermajority when Republican Scott Brown won a special election to replace the late Sen. Edward M. Kennedy (D-Mass).

As Washington tries to figure out what to do, here is some of what’s at stake for youth services:

Home Visitation

One proposal youth advocates fear is in jeopardy is a multi-million-dollar home visitation grant program and a provision to ease funding for such programs under Medicaid. Both the House and Senate health care bills include measures to provide mandatory, multi-year grants to states for evidence-based interventions that send nurses or other paraprofessionals into homes to teach child-rearing and other skills to pregnant women and new mothers. The House bill added an option to fund nurse home visitation services under Medicaid as well as the Children’s Health Insurance Program.

No funds were included in the 2010 budget for home visitation services because the administration assumed a health reform package including it would pass. And a U.S. Department of Health and Human Services (HHS) spokesman said Monday that he knew of no plans to provide a stopgap solution for the current fiscal year. The 2011 budget request is scheduled to be released next week, and it could include supplementary funds for this program and others in case health reform stalls indefinitely.

Child welfare advocates say that many randomized control group studies show that quality home visitation can reduce rates of child abuse and neglect, improve youth health and safety, and reduce chances of later involvement in the juvenile and criminal justice systems.  

A study published last month in the Archives of Pediatrics & Adolescent Medicine found that girls from families that had been enrolled in a New York Nurse-Family Partnership program – perhaps the most well-known and thoroughly studied visitation model – were less likely to enter the criminal justice system by age 19, compared with a control group.

Lauren Baker, national director of marketing and communications for Nurse-Family Partnership said this home visitation model has enjoyed bipartisan support on Capitol Hill for years. She said she was “optimistic” that the funding will come through “in one place or another.”

Medicaid Expansion

Beyond home visitation, the health care legislation has other provisions important to the overall health and development of youth, according to Tim Briceland-Betts, coordinator for government affairs at the Child Welfare League of America (CWLA). Those include an expansion of Medicaid that CWLA believes will reach more youth aging out of foster care as well as a House provision to expand Medicaid coverage for therapeutic foster care services. Subsidies to help more working families purchase health care insurance also contribute to the health and well-being of children and youth, Briceland-Betts said.

Abstinence and Teen Pregnancy

The Senate health care bill includes mandatory funding of $50 million for abstinence education and $75 million for teen pregnancy prevention that could be lost if health care reform bills are scuttled or stripped down.

“Both of these provisions could survive, neither could survive, or one or the other might survive,” Bill Albert, chief program officer for The National Campaign to Prevent Teen and Unplanned Pregnancy, said in an e-mail.

James Wagoner of Advocates for Youth, a Washington-based organization that promotes youth health and reproductive rights, said that the greater the differences in the Senate and House versions of health care, the more at risk they may be of not surviving one scenario being discussed of the House adopting the already passed Senate health care bill and then both chambers passing a measure that improves it right away through a practice called reconciliation.

“We feel strongly that whatever process is pursued here” that abstinence-only education be “dropped,” Wagoner said, while acknowledging that the teen pregnancy prevention funding he favors and other smaller provisions that “impact youth dramatically” also could “fall to the side.”

  • Tom

    You act as if a Political Party can change these problems ? NO It is OURS yours and mine as well as others responsibility to act as ambassadors to the next generation to show them not all you get is a paid position so I CARE no it is I took the time so that you hopefully don’t suffer as I did ! or my child would or that child did!  we are a model for the next to follow money does drive the social-economic-racism in other words if your part of the welfare system you must be ignorant or impaired. To some degree yes they are because of lack of knowledge or access to services that supply the basics to them a victim of society. Yet when they place these kids in foster care or other welfare based programs isn’t there any kind of mentor programs or others that question why these individuals are taking in foster kids just one example. Back in the 80s and 90s it was a money mill for the lazy. Yet it isn’t a political party that can fix this dam look at the “VICTIMS of Hurricane Katrina” Yes they were victims of social political genocide if you are poor you are ignorant and deserve what you got? was the lesson here! No it was don’t rely on a system of checks and balances that failed on that rainy day one of many. That s job is to protect its citizens from harm whether it be natural or foreign. Compassion and being a MAN WOMAN or just AMERICAN is what  these people need social networking build America back up from the political rubble and compassion of man and fellow man embracing each-other and breaking down economic barriers as well gender issues and racial issues do we need to throw out politics as a another reason to hate! drop the IRON CURTAIN in America and take down our Berlin Wall. Save Our America Please it starts right here with me and you! not some political party its to easy to blame others cause we allow them to do these things democracy is a responsibility as an American to up hold the processes and system of things and use the right to step in and HALT wrong doings by political figures as well! judges to lawyers to congress are all governed by the same as you and me laws  so if I am a person and I allow my govt local or fed or state violate or restrict ones movement or ability to pursue the right of happiness or lively hood am I not guilty of breaking the law ? so now if health care reform is  to restrict or deny access to  these children or families to medical care from my TAX dollars  or their taxes  then the lawmakers or political figures who made these cuts are actually  guilty of ABUSE and neglect and if it was you or I we would face criminal charges well America wake up it is time to file civil & criminal charges against these people if they harm Americans or children.