Washington Insider: Medicaid Reimbursement
Sign-on Letter for Home and Community Based Waivers
The Alliance for Children and Families and member agency Youth Villages are circulating a sign-on letter for The Children’s Mental Health Accessibility Act, S.3289.
It allows states to use Medicaid waivers to serve children and youth in their homes and communities, rather than in psychiatric residential treatment centers. … more
Supreme Court Upholds Most of the Affordable Care Act
The Supreme Court today in National Federation of Independent Business vs. Sebelius upheld the main provisions of the Patient Protection and Affordable Care Act (ACA), finding that Congress did not exceed their Constitutional authority in passing the legislation. Chief Justice Roberts joined Justices Bader Ginsburg, Breyer, Sotomayor and Kagan in forming the court’s majority. Justice Kennedy, thought by some to be the “swing vote,” sided with Scalia, Thomas, and Alito in dissenting to the upholding of the law. … more
The Children’s Mental Health Accessibility Act Expands Home and Community Based Waivers
Senators John Kerry (D-Mass.) and Chuck Grassley (R-Iowa) introduced The Children’s Mental Health Accessibility Act, S.3289, which allows states to use Medicaid waivers to serve children and youth in their homes and communities rather than in psychiatric residential treatment centers (PRTFs). The law would provide an expansion to all states of the waivers that have been granted under Medicaid section 1915 (c). It also removes the outdated term “mentally retarded” from the Social Security Act, replacing it with “intellectual disability.” … more
States Post Proposals on Dual Eligibles
The federal government last year announced initiatives to help states improve the quality and lower the cost of care for the approximately 9 million individuals who are eligible for both Medicaid and Medicare. These “dual eligibles” represent a disproportionate amount of spending in both programs because of their high level of need. They make up 15 percent of Medicaid beneficiaries, but account for almost 40 percent of costs. … more
Landmark Foster Care Settlement
A class action lawsuit, Katie A. v. Bonta, that started in California in 2002 has finally reached a settlement. It outlines a comprehensive reform strategy for the state and attempts to cure an overarching problem facing many states: the difficulty of aligning mental health services with the child welfare system.
Mental health and child welfare often work in silos, despite the fact that, according to the complaint, up to 85 percent of foster children have mental health needs. The class action suit was brought against the state of California for failure to assess and treat mental health needs of children who were either in foster care or at imminent risk of coming into care. … more
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About the Author

Katherine Astrich is senior vice president of public policy and mobilization for the Alliance and UNCA.
She previously worked as a consultant for The Lewin Group, a national health and human services consulting firm. She has advocated for Medicaid, early education, and workforce assistance programs that benefit vulnerable children and families.
Her expertise includes regulatory and information collection policy. She also has eight years of experience working for the Office of Management and Budget. ... more
About the Author
Cecilia Fiermonte is director of child welfare policy at the Alliance. An attorney, she previously was assistant director at the American Bar Association Center on Children and the Law, advocating for policy change and providing training and technical assistance.
She also previously:
- Supervised the child welfare program of the County Attorney's Office in Wyoming County, N.Y.
- Worked in research and evaluation at the Quality Improvement Center on the Representation of Children
- Represented children in family court matters ... more
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