On Tuesday, August 20 key hill staffers in the House of Representatives brought together 4 national organizations to discuss a proposal that would, in effect, mix and match sections of the passed House bill and the Senate bill now awaiting floor action. In essence, if an agreement of this sort were reached prior to the floor action on the Senate bill and then presented with the Senate bill as a manager's amendment, it would basically eliminate the need for a conference as the two versions of the bill would be merged and approved by the Senate. The House would then pass this new hybrid bill and the IDEA would be reauthorized.
Unfortunately, the three onerous amendments discussed here last week are still part of this new proposal. House staff has given verbal assurances that these provisions would be discussed as a part of the compromise proposal. NPND will continue to work with anyone interested in passing a fair, evenhanded reauthorization of the IDEA. However, NPND continues to oppose the three previously mentioned amendments and on that basis alone, opposes this latest proposal.
Other indicators of Senate action in September also occurred in Mississippi immediately following the summer recess. In a meeting with parent leaders, Senate Majority Leader Lott indicated that he expected to pass the IDEA in September. He did not address any of the specifics of the bill.
The call for action embodied in last week's Friday Fax is still relevant and needed. We need to communicate our intense displeasure with the latest amendments and to urge passage of S. 1568 without any further weakening amendments. We need to communicate with Senators who are in their home state now! Also, don't forget the national call in day on September 3, 1996. Contact your Senators by calling 1-800- 962-3524 or 1-202-224-3121.
On Thursday, August 22 the President signed into law the so called "Welfare Reform" bill. Ending "welfare as we know it". The Bazelon Center for Mental Health Law has issued a thorough analysis of the impact of this law upon the Children's SSI program. Highlights of these impacts include:
• The law includes a new, more narrow definition of childhood disability that may limit eligibility for children with very significant physical or mental functional limitations. The new definition requires that a child have a "medically determinable physical or mental impairment which results in marked and severe functional limitations" of substantial duration. This definition may limit eligibility for children who have a combination of impairments if no single condition matches a medical impairment on SSA's listing.
• Children will no longer be able to qualify through an individualized functional assessments (IFA). The IFA established after the Zebley decision is eliminated by this legislation. In many states up to one third of children who were found eligible since Zebley qualified through the IFA. Children can now qualify only through the more restrictive medical listings. SSA will re-evaluate each child who qualified through an IFA to determine if he or she will remain eligible through the medical listings. SSA has one year from the date of enactment to accomplish these redeterminations. SSA data indicate the percentage of children within diagnoses, who will lose access to SSI by elimination of the IFA include 49% of those with mood disorders; 38% of those with pulmonary tuberculosis; 33% of those with mental retardation; 29% of those with burns; 25% of those with intercranial injuries; 22% of those with schizophrenia; and, 22% of those with arthritis. In all, the Congressional Budget Office (CBO) estimates that 267,000 children will lose access to benefits over the next six years as a result of the IFA's elimination.
• The medical listings will be modified to eliminate references to "maladaptive behavior" when evaluating personal/behavioral functioning for children with mental impairments. The CBO estimates that, over the next six years, another 48,000 children will lose access to benefits as a result of this change in the mental impairment listings.
• Up to 50,000 children will lose access to health care through the Medicaid program.
For a more detailed description of the devastating impact of Welfare Reform on the children's SSI program contact Rhoda Schulzinger, Bazelon Center for Mental Health Law, 202-467-5730; e-mail (with her name in the subject line): hn1660@handsnet.org.
There are currently internal plans afoot to reorganize HRSA. Part of that plan suggests that the Bureau structure of HRSA be eliminated. Apparently, assurances have been given that the programmatic centers of the Bureau would continue to exist but in a different administrative structure. Should programmatic services involving children be weakened or submerged under other priorities, the potential impact of this proposal could be devastating to poor mothers and children throughout the country. It is anticipated that this reorganization will occur within the next three months. It is critical that families and all concerned individuals communicate with policy makers in their state as well as here at HHS to explain what maternal and child health (Title V) services really mean.
On an even faster track, President Clinton has proposed an amendment to the FY'97 that would reduce funding for MCH SPRANS grants by $5 million. Due to the rotating funding scheme of SPRANS projects the proposed reduction would reduce available funding by roughly 20%. This cut could happen within the next few weeks.
We will be issuing fax fact sheets on these issues in the very near future. Those of you already versed in MCH need to get active now.