CSSP.org Blog http://www.cssp.org/media-center/blog/rss CSSP.org Blog Feed Thu, 23 Apr 2015 05:00:00 +0000 AMPS en hourly 1 New CSSP Brief: Religious Refusal Laws in Child Welfare - Harming Children and Stunting Progress http://www.cssp.org/media-center/blog/new-cssp-brief-religious-refusal-laws-in-child-welfare-harming-children-and-stunting-progress Tue, 17 Oct 2017 12:36:00 -0500 http://www.cssp.org/media-center/blog/new-cssp-brief-religious-refusal-laws-in-child-welfare-harming-children-and-stunting-progress Last week, after announcing the reversal of a three year old Justice Department policy that protected transgender employees from workplace discrimination, Attorney General Jeff Sessions issued two memos addressing the federal interpretation of religious liberty. The memos broadly interpret religious liberty to allow businesses covered under Title VII of the Civil Rights Act of 1964, including federal service providers, to refuse to serve people on the basis of the employer’s religious beliefs. This decision follows the trend initially set by the Trump Administration through a leaked draft of an executive order on religious liberty and picked up by several states across the country that have passed religious refusal legislation that allow publicly-funded child welfare agencies to refuse to serve individuals based on their deeply-held religious belief. While religious refusal laws may be intended to provide religious child placing agencies protection from adverse action for discriminating against prospective foster and adoptive parents who are LGBTQ or gender expansive, they will have numerous, far-reaching and harmful consequences for all young people involved in child welfare.

This week, CSSP released a new brief, “Religious Refusal Laws in Child Welfare—Harming Children and Stunting Progress”, examining the impact of religious refusal legislation on children and families who are involved in child welfare. As we discuss in the brief, religious refusal laws will have tremendous negative consequences for all children and families involved in child welfare that directly contradict not only the basic principles of child welfare but also the significant gains made by child welfare systems across the country to recruit and retain quality foster and adoptive homes. These consequences include:

  • A reduction in the number of available homes for children and increased time in foster care. Agencies could reject otherwise qualified unmarried couples, individuals who are single or divorced, people of a different faith than the agency, interfaith couples, families and individuals who do not belong to a religious practice or lesbian, gay, bisexual, transgender, queer (LBGTQ) or gender expansive individuals or couples because they do not adhere to an agency or individual worker’s beliefs. This would result in children remaining in foster care rather than being placed in a loving, capable and qualified adoptive home. It could also increase referrals to group and congregate care facilities due to lack of available foster homes.
  • Educational disruption. Religious refusal laws increase the likelihood that children entering foster care will have to move further away from their home school for their placement and experience education disruption. Research shows that educational disruption has a number of long-lasting, detrimental effects on students’ academic achievement, brain growth, mental development, psychological adjustment and likelihood of high school completion.
  • Disconnection from family and other supportive social networks. Religious refusal legislation would allow an agency to refuse to place a child with an otherwise qualified relative or family friend for multiple reasons related to the agency or individual worker’s religious beliefs and instead place the child in non-relative foster care or in a group or congregate care facility.
  • Lack of access to appropriate medical and behavioral health care. Limiting potential foster and adoptive placements increases the likelihood that children in foster care will experience disruptions in their medical or behavioral health care. Moreover, an agency could deny children and young people necessary medical care, such as vaccinations, reproductive care or access to contraception, which runs counter to the work of jurisdictions throughout the country to ensure that all children in foster care are vaccinated, receive regular medical and dental care and are screened and receive access to any identified mental health care.
  • Additional harm for lesbian, gay, bisexual, queer, transgender and gender expansive young people in foster care. By allowing agencies to discriminate against LGBTQ or gender expansive foster or adoptive parents, religious refusal laws send a clear and powerful message that the public agencies charged with protecting youth who have been rejected by their families will further repeat that trauma and validate such rejection by not supporting or affirming their identities. In addition, placement of young children in non-affirming homes can result in abuse and failed adoptions later when a child comes out in that home.

These outcomes are far from inevitable. We call upon policymakers and advocates to join the many states and communities who are rejecting religious refusal laws that provide publicly-funded agencies with a license to discriminate and are instead working to ensure that child serving agencies focus on promoting the best interests of all children in their care through inclusive nondiscrimination laws and providing them with capable, loving and stable homes.

For more information on the harmful consequences of religious refusal laws in child welfare, read our brief available here.

For more information on strategies for child welfare systems to better support healthy sexual and identity development for all children and youth in the child welfare system, see resources from CSSP’s getREAL (Recognize, Engage, Affirm Love) Initiative.


 Rosalynd Erney is a policy analyst at CSSP.

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Fight For Our Girls: Applying an Intersectional Lens to Girls of Color Facing Status Offenses http://www.cssp.org/media-center/blog/fight-for-our-girls-applying-an-intersectional-lens-to-girls-of-color-facing-status-offenses Thu, 12 Oct 2017 12:00:00 -0500 http://www.cssp.org/media-center/blog/fight-for-our-girls-applying-an-intersectional-lens-to-girls-of-color-facing-status-offenses CSSP’s Alliance for Racial Equity in Child Welfare’s second brief in the Fight for Our Girls series centers the importance of crafting a more holistic narrative for girls of color who are involved in public systems. The brief suggests this narrative can be achieved by systems applying a trauma-informed approach and intersectional lens when developing programs, policies and practices.

Public systems often subject girls – disproportionately girls of color– to harsher punishments for lower-level crimes and status offenses. In fact, girls who commit these behaviors - such as running away, missing school and violating curfew – can be narrowly defined as social problems that require intervention at the individual level. It is important to avoid conceptualizing status offenses as individual problems or as social problems. Instead, a trauma-informed approach should consider what underlying factors may be leading girls to these behaviors. For example, behaviors like running away, truancy and violating curfew are often methods of survival and are likely caused by underlying trauma such as abuse, commercial sexual exploitation and family conflict.

In addition to the high likelihood that girls are committing status offenses as methods of survival is the challenge of adults’ perceptions of girls, especially on girls of color. The latest Fight for Our Girls brief outlines research conducted by Lisa Pasko, which found that girls, and disproportionately girls of color, face added challenges such as biases, stereotypes and historic oppression when coming in contact with public systems. Pasko’s research, which consisted of interviews with probation officers, social workers, therapists and residential placement staff, revealed that system stakeholders have a hyper focus on policing girls for their perceived sexuality rather than focusing on their overall well-being.

Adultification is yet another challenge that arises for girls of color that can be attributed to adult perception. The recently released Girlhood Interrupted report cites adultification of Black girls as problematic beliefs that they need less nurturing, less protection, less support, less comfort, are more independent and that they know more about sex and other adult topics.

Fight for Our Girls points to recent research to uncover the racial, ethnic and gender biases that may be leading girls of color to be subjected to disparate treatment for status offenses.

Juvenile justice and child welfare systems must work to address the structural inequities and trauma that so often contribute to girls committing status offenses in order to fully support the ability of girls of color to thrive. The latest Fight for Our Girls brief highlights successful organizations that are working to change this narrative and puts forth the following recommendations: Public systems should (1) collect and report data that captures the involvement of youth in child welfare systems for status offenses, (2) develop meaningful cross-systems partnerships, (3) implement community-based prevention models that promote youth stability and placement in the community, (4) utilize youth advisory boards and youth engagement strategies to inform effective program development and implementation, (5) fully implement the reauthorized Juvenile Justice and Delinquency Prevention Act, and (6) create safe and affirming spaces for LGBTQ youth and transgender girls of color.

To learn more, read the full brief here.

Don’t forget to join us on Thursday, October 26, 3-4 p.m EST for our #FFOG: Fight For Our Girls Twitter Chat.

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Erika Feinman is a program and research assistant at CSSP.

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An Accelerating Change Awardee Profile: Gwen's Girls http://www.cssp.org/media-center/blog/an-accelerating-change-awardee-profile-gwens-girls Tue, 10 Oct 2017 13:19:00 -0500 http://www.cssp.org/media-center/blog/an-accelerating-change-awardee-profile-gwens-girls


On September 27th, CSSP announced three winners of the 2017 Accelerating Change Award. Each of the awardees have demonstrated a commitment to reaching and serving diverse populations of young women and girls of color who are involved or at risk of involvement in public systems.

“We are honored to receive CSSP’s 2017 Accelerating Change Award and to be recognized by an entity that is so dedicated to racial equity for girls. We are of the belief that positive impact only happens when we work together,” said Amy Yeu, a program coordinator at Gwen’s Girls. “We are proud to join hands with those accomplishing the same goal: to lift girls out of at-risk situations and into their potential.”

Based in Pittsburgh, Pennsylvania, Gwen’s Girls was founded in 2002 by the late Police Commander Gwendolyn J. Elliott. Commander Elliott became the first Black woman to serve as a commander on the Pittsburgh Police force in 1986. During her tenure on the force, she witnessed the struggles of young women and girls involved with law enforcement. Her experience fueled her determination to ensure that all young women and girls could lead successful and fulfilling lives. Commander Elliot’s legacy of determination to help young women and girls continues to live through Gwen’s Girls’ mission of providing young women and girls with gender-specific programs, education and opportunities to foster leadership and joy.

Young women and girls of color – especially those involved in public systems – face a unique and alarming trajectory that puts them at risk of poor outcomes. Gwen’s Girls works to disrupt this trajectory through its programs which address the needs of young women and girls in a holistic and comprehensive manner using a strengths-based approach. The programs at Gwen’s Girls build on each young woman and girl’s personal strengths and provide opportunities and experiences for her to be successful.

Gwen’s Girls advocates for the holistic care of young women and girls through its community programs, strengths-based prevention services and various outreach initiatives and trainings. Fifteen years after its inception, Gwen’s Girls continues to service 300 young women and girls a year through residential care, community education, after school and summer programs, STEM, health and wellness and workforce development programming. The organization also provides opportunities for young women and girls to participate in community advocacy and activism within Pittsburgh and Allegheny County. Through Gwen’s Girls various programs and services, many of the organization’s participants achieve academic success, lack of re-involvement in the justice system, and reduced incidences of unplanned pregnancies.

Continuing in the footsteps of its founder and her experience on the Pittsburgh Police force, Gwen’s Girls recognizes the importance of addressing how public systems respond to the needs of young women and girls. In 2016, Gwen’s Girls’ inaugural Equity Summit was a catalyst for the creation of the Black Girls Equity Alliance, a grassroots movement comprised of over 50 organizations and community members, which intends to help affect lasting change for Black girls in public systems.

In addition to national recognition and an honorarium, Gwen’s Girls will join other Accelerating Change Award recipients to be part of a network of similar initiatives to share ideas and help accelerate positive change and promising futures for women and girls of color nationally.

To learn more about Gwen’s Girls, please go to www.gwensgirls.org

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Victoria Efetevbia is a program and research assistant at CSSP.

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Gender, Sexuality and Parenting http://www.cssp.org/media-center/blog/gender-sexuality-and-parenting Wed, 04 Oct 2017 12:02:00 -0500 http://www.cssp.org/media-center/blog/gender-sexuality-and-parenting We are living in a time of rapidly evolving social norms and understanding of the spectrum of human experiences with sexual orientation, gender identity and expression (SOGIE). (See the Genderbread Person image for an explanation of what is meant by each of these terms and how they make up each individual’s SOGIE.)

In this blog post, we address some key questions about SOGIE and parenting. How should parents respond when their young children embrace a gender identity and/or expression that doesn’t line up with expectations? How should parents respond when their teenage or young adult children come out? What commitments do foster and adoptive parents make to accept the children and young people they bring into their families? On the other side of the parenting equation, does a parent’s SOGIE matter to their ability to love and nurture children? Should parents’ SOGIE be taken into consideration as systems try to find homes for the children needing families in this country?

Progress, Opposition and the Real Cause for Concern

From the legalization of gay marriage to greater acknowledgement and acceptance of transgender people in schools, places of business and the media, progress on these issues is apparent across our society. The scientific and human services communities have kept pace with this evolution. Gender clinics now exist to support parents who are trying to understand and support their children who are finding their way along this spectrum. Organizations such as Gender Spectrum based in Berkeley, California provide resources and supports to children, youth and families.

While this evolution has moved in a progressive, thoughtful and supportive way to ensure healthy development of children, youth and families, not everyone has responded well to these changes. Some individuals and organizations view greater acceptance as wrong. Some see it as an attack on their values and their view of our society. Some families have been reported to child protective services, and many more have faced criticism or harassment, due to others’ concerns about how they respond to their young children’s gender expression. Other parents face scrutiny or legal obstacles to parenthood due to their own sexuality or gender identity. And despite greater acceptance in our society as a whole, too many LGBT and gender non-conforming children and adolescents still face hostility, bullying and rejection from their families and peers.

Strict enforcement of gender norms and rejection of children and adolescents’ true selves has an unacceptable cost in terms of teen suicide, high numbers of runaway/homeless youth, juvenile incarceration and sex trafficking. Many young people end up in the child welfare system because their families have rejected them due to their sexual orientation or gender identity. Children and youth experience this in their birth families as well as in foster families and adoptive families; tragically, some experience it more than once.

Pushing strict gender norms is not only harmful to children who are questioning their gender or sexuality. It also perpetuates the effects of a gender binary frame, which has contributed over time to incidents of domestic violence, bullying and other behaviors grounded in an unhealthy belief that power and control are priorities. Everyone benefits when we move beyond that binary thinking.

What Does Good Parenting Look Like?

All children need to be loved, affirmed and supported. . With partners at Family Builders By Adoption in Oakland, California, getREAL developed a guide, Raising Healthy and Happy LGBT & Gender Non-Conforming Children, to help parents navigate what may be unfamiliar terrain. Birth parent, foster parent or adoptive parent, it boils down to being loving, supportive, accepting and open with your child, and advocating for them with other people or institutions (like church or school) that may not be as supportive.

This is actually a good approach to parenting regardless of a child’s SOGIE. All children need unconditional love and support from their families, and all children benefit from an open and accepting approach that encourages them to express their emotions, follow their interests and explore all aspects of their own identity. Parents who allow their children that freedom – without enforcing strict norms of masculinity or femininity – will see their children grow and thrive.

Through getREAL, the Center for the Study of Social Policy (CSSP) works to help (or in some cases encourage) public systems and agencies to update their policies and practices so that they can better serve, and not further harm, all of the young people they serve. While there may not be a lot we can do in the policy realm to ensure that birth parents will love their children unconditionally, systems can take steps to reduce the likelihood of failed adoptions or foster placements based on lack of knowledge or unwillingness to accept a child’s SOGIE. For example, they can educate potential foster and adoptive parents, ask them about their commitment to keeping a child in their family regardless of the child’s emerging gender identity and sexual orientation and provide access to gender clinics and other supports as needed.

What About Parents’ SOGIE?

Some people have a related concern about how parents’ SOGIE affects their ability to raise children – or how it should affect their rights to do so, as we see in recent moves by some state legislatures and faith-based organizations to limit the rights of LGBT adults to become foster or adoptive parents.

An adult’s SOGIE, relationship or marital status has no bearing on their ability to raise a child – in fact, research indicates that children of gay and lesbian parents are less likely to be abused or neglected, and more likely to thrive, than other children. (See a summary of relevant research: Patterson, C. J., & Farr, R. H. (2015). Children of Lesbian and Gay Parents: Reflections on the Research–Policy Interface. The Wiley Handbook of Developmental Psychology in Practice: Implementation and Impact, 121.There is no justification for keeping LGBTQ parents from bringing children into their families – through foster care, kinship care, adoption, surrogacy or otherwise.

What Kinds of Support Do Families Need?

CSSP’s Strengthening Families Protective Factors Framework describes characteristics that all families need to support optimal child development and reduce the likelihood of child abuse and neglect, while our Youth Thrive framework describes a parallel set of protective and promotive factors that young people need to thrive. All families and youth need support to build and maintain these protective factors throughout their lives.

Through the lens of these protective and promotive factors, it becomes easier to understand some of the challenges that families and youth can face, as well as the types of support they might need as they navigate issues of SOGIE. What support can we provide so that all families can love, affirm and support their children to become their authentic selves, able to love and embrace all aspects of their identity?

PROTECTIVE FACTOR

SUPPORT NEEDED

Parental and youth resilience: Managing stress and functioning well when faced with challenges, adversity and trauma Parents may question their own ability to parent their children who are questioning their sexuality or gender orientation, being bullied at school or otherwise struggling. Parents may benefit from support groups such as PFLAG.

Young people who are questioning their sexuality or gender orientation, or who are being bullied, need reassurance that they will be loved and supported regardless of their SOGIE. Resources like the It Gets Better Project can help young people see a positive future for themselves despite their current situation.
 Social connections: Positive relationships that provide emotional, informational, instrumental and spiritual support

Young people may benefit from connecting with peers who are similarly developing. Parents, too, benefit from connecting with others who are facing similar parenting situations. 

For both parents and youth, acceptance and support from their extended families and friends is also critical. 
 Knowledge of parenting and child development: Understanding child development and parenting strategies that support physical, cognitive, language, social and emotional development  Parents need additional knowledge about SOGIE if their child is gender-nonconforming or gay; young people also need access to this information about their own development. Books such as Dr. Diane Ehrensaft’s Gender Creative Child can be very helpful.
Concrete support in times of need: Access to concrete support and services that address a family’s needs and help minimize stress caused by challenges   Access to supports such as gender clinics and parent support groups is critical when a young child says their gender is different than their sex at birth or when a youth is questioning their sexual identity or says they think they are gay.
 
Young people whose families are not accepting of their SOGIE will need additional concrete supports, up to and including housing and financial support if their families reject them. 
Social and emotional competence of children / Cognitive and social-emotional competence of youth: Family and child interactions that help children develop the ability to communicate clearly, recognize and regulate their emotions and establish and maintain relationships   Parents need to understand the impact of family acceptance vs. rejection behaviors on health outcomes for children and strategies to support their child’s social-emotional development. (See familyproject.sfsu.edu/publications.) 

Young people need to experience love, affirmation and acceptance – from their families, friends, teachers and other supportive adults – to support their own development and self-esteem.


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Cailin O'Connor is a senior associate at CSSP and Bill Bettencourt is a senior fellow at CSSP.

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Congress Missed the Deadline to Reauthorize CHIP: What Happens Now? http://www.cssp.org/media-center/blog/congress-missed-the-deadline-to-reauthorize-chip-what-happens-now Tue, 03 Oct 2017 12:24:44 -0500 http://www.cssp.org/media-center/blog/congress-missed-the-deadline-to-reauthorize-chip-what-happens-now Saturday came and went and Congress failed to reauthorize the Children’s Health Insurance Program (CHIP), a popular health program that provides coverage to the 9 million children who rely on it. The urgency to reauthorize CHIP was not news to Congress as advocates have been voicing the strong and unified message on the need for a five-year extension of the program for some time. Yet Congress allowed the funding for CHIP to lapse, having spent the better part of the year attempting instead, to repeal the Affordable Care Act (ACA). 

Now it appears that the House Energy and Commerce Committee is planning to take up a package tomorrow, the same day that the Senate Finance Committee is expected to consider The Keeping Kids Insurance Dependable and Secure Act (S. 1827) - a bipartisan bill to extend funding for CHIP for five years. The House package will include, in addition to a five-year reauthorization of CHIP, funding for community health centers and for Puerto Rico over a two-year period, in addition to other health-care extenders. While there will likely be movement on CHIP this week, there are a few sticking points. The House Energy and Commerce Committee has identified its pay-fors for the package but the Senate Finance Committee has not. Also, no Democrats have yet signed on to the House bill. 

While we wait for Congress to act, States are now planning internally for the end of CHIP funding, with some states beginning to shut down their programs within a few months – leading to significant disruptions in children’s coverage. Aside from being compelled to impose enrollment freezes which would barre new applicants from obtaining coverage, states must also begin the process of informing families that their children will be dis-enrolled from healthcare coverage. While many States have funding through the end of the year, they have to immediately begin making system changes to prepare for shutting their programs down. 

As States look ahead to freezing enrollments and shutting down programs, they continue to make difficult day-to-day decisions, for instance, around vaccine purchases. These decisions must be made early. As we head into flu season, states buying vaccines on a quarterly basis will have to decide now whether to buy vaccines for winter 2017-18. Without funding certainty, many states will find it difficult to make these decisions and could be forced not to purchase vaccines.  For low-income families, access to such preventative services is essential. 

According to the Kaiser Family Foundation, at least 10 states are expected to exhaust their CHIP funds by the end of 2017 and 32 states project they will exhaust federal funds as of the end of March 2018. The states likely to be hardest hit are Utah, Minnesota, Arizona, Texas, West Virginia and Nevada. Of these, Utah has stated that it will run out of funding by the end of the year and is making plans to close the program and Nevada is preparing to freeze enrollment on November 1 and to end coverage altogether on November 30. 

CHIP must stay strong so that health care remains accessible and of high-quality for families with young children facing barriers to coverage. As this week unfolds, Congress must move quickly to enact a five-year extension of CHIP.

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Shadi Houshyar is a senior associate at CSSP and Rhiannon Reeves is a policy analyst at CSSP.

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SNAP at 40: Alleviating Hunger and Lifting Families from Poverty http://www.cssp.org/media-center/blog/snap-at-40-alleviating-hunger-and-lifting-families-from-poverty Fri, 29 Sep 2017 11:54:00 -0500 http://www.cssp.org/media-center/blog/snap-at-40-alleviating-hunger-and-lifting-families-from-poverty Today is the 40th anniversary of the passage of the Food Stamp Act of 1977, which set the framework for the current Supplemental Nutritional Assistance Program (SNAP). As SNAP and other social programs face potential structural changes or reductions in funding in current reauthorization and budgetary proposals, it is important to take a step back to evaluate how SNAP has worked to alleviate hunger and lift families from poverty over the past 40 years.

SNAP Combats Food Insecurity. SNAP has long functioned as a critical food assistance program for individuals and families facing food insecurity.[1] In 2015, SNAP helped more than 45 million individuals and families afford nutritionally adequate food. SNAP also has a significant impact on the well-being of children – with research showing that SNAP benefits can reduce food insecurity among children by 20 percent and improve their overall health by 35 percent. Another study found that SNAP participation reduced households’ food insecurity by about five to ten percentage points and reduced “very low food security,” which occurs when one or more household members have to skip meals or otherwise eat less due to lack of money, by about five to six percentage points.

SNAP Reduces Poverty. According to the Supplemental Poverty Measure, after Social Security Income and refundable tax credits, SNAP is the most effective federal program in lifting families out of poverty, lifting  3.6 million people out of poverty in 2016. SNAP is also structured so that families with the greatest financial need receive the most benefits. Research shows that 93 percent of SNAP benefits go to households with incomes below the poverty line ($19,377 for a single parent with two children in 2016) and 58 percent go to families in deep poverty whose incomes are below half the poverty line ($9,689 for that same family in 2016). Research also shows that SNAP reduced the number of families with children living in extreme poverty, defined as earning less than $2 per person per day, by more than 48 percent and cut the number of children living in extreme poverty by more than half in 2011. Individuals with low incomes have to spend all of their monthly income meeting daily necessities, including shelter, food and transportation. Every dollar provided through SNAP to low income individuals and families for food allows them to spend an additional dollar on other necessities.

SNAP is Critical to the Safety Net. SNAP is one of the only federal means-tested benefit programs that is broadly available to almost all low income households. SNAP is able to respond quickly and effectively to support low income families and communities during times of increased need because of its structure as an entitlement program, meaning that anyone who qualifies under the program can receive benefits. Research shows that during times of economic downturn, enrollment in SNAP expands while enrollment declines when the economy recovers. Other than unemployment insurance, SNAP has been shown to be the most responsive federal program in providing assistance to low income families and communities during times of recession.

As we mark this anniversary – it is important to think not just about SNAP itself – but of the countless children and families who are better off because of it. There are few more basic needs than having adequate, healthy food. The SNAP program helps families meet that need during their toughest times – and is structured so that eligible families are not turned away. At CSSP, we are committed to ensuring that families have every possible opportunity to be healthy and successful – and access to healthy food is absolutely essential to that goal.

For more information on SNAP and its impact on supporting children and families, please see our publications Food Insecurity in Early Childhood and Supporting Youth Aging Out of Foster Care Through SNAP.


[1] The concept of “food security” is used by the U.S. Department of Agriculture (USDA) to measure a household’s social and economic ability to access adequate food. Food insecurity of any degree indicates a lack of resources needed to meet basic needs, and a risk of poorer health and wellness outcomes due to lower quality nutrition.

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Rosalynd Erney is a policy analyst at CSSP.

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New Report Notes Violence Against the LGBTQ+ Community is On the Rise http://www.cssp.org/media-center/blog/new-report-notes-violence-against-the-lgbtq-community-is-on-the-rise Fri, 29 Sep 2017 10:05:00 -0500 http://www.cssp.org/media-center/blog/new-report-notes-violence-against-the-lgbtq-community-is-on-the-rise In August, the National Coalition of Anti-Violence Programs (NCAVP) released a new report, A Crisis of Hate: A Mid Year Report on Lesbian, Gay, Bisexual, Transgender and Queer Hate Violence Homicides. Typically, these reports are published annually. However, NCAVP decided to release this report early with hopes that it will raise awareness of the increased violence faced by the LGBTQ+ community. NCAVP has been tracking violence against the LGBTQ+ community for 20 years and NCAVP has recorded the highest number of anti-LGBTQ homicides just over halfway through 2017. This is an alarming fact, especially when considering that this number will likely grow, as the year 2018 is still several months away.

As of August 23rd, 2017, NCAVP recorded reports of “36 hate violence related homicides of LGBTQ and HIV affected people,” a 29 percent increase from 2016. In an attempt to further break down the data NCAVP collected, the report states that for the year 2017 thus far, “there has been nearly one homicide a week of an LGBTQ person in the U.S.” While this report demonstrates a stark increase in violence against all LGBTQ+ individuals, perhaps what is most disturbing is the increased number of transgender women of color who were the victims of homicides. Of the 19 murders of transgender and gender expansive individuals in the first half of 2017, 16 were transgender women of color. Notably, this report was published prior to the horrific murders of 28-year-old transgender man Kashmire Nazier Redd, nonbinary student activist Scout Schultz, 26-year-old transgender woman Derricka Banner and transgender teen Ally Steinfeld. This means that in the month since this report was published, the count of transgender and gender expansive homicides has increased by 16 percent, from 19 to 22, tragically surpassing the data reported in 2016.

In addition to this trend, there has also been a significant increase in reported violence and homicides against gay, bisexual and queer cisgender men. In 2016, four gay, bisexual and queer cisgender men were victims of homicide. For January through August of 2017, 17 cisgender gay, bisexual and queer men were murdered and over half (53 percent) of these victims were men of color. Despite increasing trends of violence against LGBTQ+ communities, data shows that people of color, transgender women of color, and queer, bisexual and gay cisgender men are more often the targets of anti-queer and racist violence. The fact that these groups experience oppression at the intersection of multiple identities – race, ethnicity, gender – undeniably contributes to these individuals facing higher levels of violence and higher murder rates than other members of the LGBTQ+ community experience.

While this report makes significant contributions to better understanding violence against some of the most at risk populations, data are limited. The number of homicides of LGBTQ+ people is likely higher. NCAVP cites several challenges to accurate data collection, such as the misidentification of victims’ sexual orientation and/or gender identity in police reports and the media. In addition, they note the media and law enforcement’s reluctance to categorize a crime as being related to bias.

A Crisis of Hate attributes the increase in anti-LGBTQ+ homicides in part to the turbulent political climate of the U.S. However, the report does not attribute these trends to any specific instance, policy change or otherwise. While the report does not propose solutions to the crisis, there are several organizations, states, cities and localities that are initiating actions to protect LGBTQ+ people in their communities, including:

  • Partnering with LGBTQ+ community members in creating LGBTQ+ task forces. DC Metropolitan Police Department’s Lesbian, Gay, Bisexual and Transgender Liaison Unit (LGBTLU) focuses on the safety needs of DC’s LGBT community, conducts public education campaigns on hate crimes and public safety, seeks to end hate crime and violent crime within the LGBT community and conducts patrols and responds to citizen complaints. These units are most effective when they partner with individuals from the local LGBTQ+ community every step of the way.
  • Decriminalizing sex work. Sex work is more common and also more dangerous for LGBTQ+ individuals. In addition to LGBTQ+ individuals being more likely to engage in sex work to survive, LGBTQ+ sex workers are also nearly 2.5 times more likely to be attacked with a gun than other sex workers. Decriminalizing sex work would help keep LGBTQ+ sex workers safe by enabling them to access necessary resources and by protecting them from violent law enforcement. California is one state example where sex work has been decriminalized for minors with the passage of SB 1322 in 2016.
  • Prohibiting discrimination based on sexual orientation and gender identity. Illinois became the most recent state to add gender identity to the list of protected categories in hate crime law, joining Washington, DC, Minnesota, California, Vermont, Puerto Rico, Hawaii, New Mexico, Colorado, Maryland, New Jersey, Oregon, Washington, Rhode Island, Delaware and Nevada. States that currently have sexual orientation covered in hate crime statute include California, Connecticut, Wisconsin, Minnesota, Nevada, Oregon, Washington, DC, New Jersey, Vermont, Florida, Illinois, New Hampshire, Iowa, Maine, Texas, Washington, Massachusetts, Delaware, Louisiana, Nebraska, Rhode Island, Missouri, Kentucky, New York, Tennessee, Kansas, Puerto Rico, Arizona, Hawaii, New Mexico, Colorado and Maryland.
  • Creating LGBTQ+ inclusive policies. LGBTQ+ individuals are more likely to be turned away from homeless shelters and face a heightened risk of abuse, violence and exploitation. Transgender people are especially at risk, with some homeless shelters barring them from entering. Nonprofit homeless shelters that are specifically for homeless LGBTQ+ individuals have begun to pop up across the US to accommodate the needs of this community. A few examples of these shelters include Casa Ruby, The Wanda Alston Foundation, Project Fierce Chicago, and New Alternatives for Homeless Youth. These initiatives should be supported in conjunction with reforming policies of non-LGBTQ+ specific homeless shelters to ensure that LGBTQ+ individuals always have a place to go.
  • Promoting safe and inclusive transportation. Homobiles, a non-profit in California, offers safe, reliable, pay-what-you-can, 24/7 transit for the LGBTQ+ community. Buses, taxis, subways, and walking have proven to be unsafe modes of transportation for queer people, especially in urban areas and especially at night.

While many cities and localities have made strides toward protecting and supporting their LGBTQ+ community members and their allies, protections currently in place for this population are not sufficient. CSSP remains committed to working with our partners across the country to promote policies and practices that support, uplift and protect all people from violence and discrimination based on sexuality, gender identity, race, ethnicity, ability and immigration status. 

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Erika Feinman is a program and research assistant at CSSP.

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A Five-Year Reauthorization of CHIP is Needed Now http://www.cssp.org/media-center/blog/a-five-year-reauthorization-of-chip-is-needed-now Thu, 28 Sep 2017 10:33:00 -0500 http://www.cssp.org/media-center/blog/a-five-year-reauthorization-of-chip-is-needed-now On Monday, the Senate Finance Committee held a hearing to consider the Graham-Cassidy proposal, the latest Affordable Care Act (ACA) repeal measure which would make devastating cuts to marketplace insurance subsidies, Medicaid expansion, and the Medicaid program by converting Medicaid funding into block grants to states. The measure failed to move to a roll call vote as three Senate Republicans announced that they would not support it, sounding a clear victory for the millions of Americans who rely on Medicaid, including nearly 37 million children. The bill’s failure ends any chance Republicans had of repealing the ACA before year’s end and likely in the foreseeable future.

While the most recent ACA repeal effort monopolized the attention of lawmakers, the Children’s Health Insurance Program (CHIP) and its future were sidelined. With current CHIP funding set to expire on Saturday, September 30th, the Senate Finance Committee has taken important steps to ensure that the program continues to provide health coverage to the 9 million children who rely on it. The Committee held a hearing on CHIP earlier this month, and on September 18th, took an important step toward ensuring uninterrupted funding for the program by releasing The Keeping Kids Insurance Dependable and Secure Act (S. 1827) - a bipartisan  bill to extend funding for CHIP for five years. The House has yet to act although it may look to mark up a package that includes funding for CHIP, community health centers and other extenders this week. There is limited time left and Congress must act now. The CHIP bill must be signed by September 30th before current funding expires.

Currently, 95 percent of children in the United States have health coverage – a historic high – thanks in large part to Medicaid and CHIP, which together, have cut the uninsured rate for children by more than two-thirds over the last two decades.

Currently, 95 percent of children in the United States have health coverage – a historic high – thanks in large part to Medicaid and CHIP, which together, have cut the uninsured rate for children by more than two-thirds over the last two decades. CHIP, a companion program to Medicaid, provides coverage for uninsured, low-income children who fail to qualify for Medicaid and lack access to other coverage options. The two programs play a critically important role for all low-income children, but are especially vital for children of color, helping to reduce disparities in health care access and service provision, improve continuity in care and advance health equity over time.

The last CHIP reauthorization extended the program through September 30, 2017, with federal CHIP allotments available to states until FY 2018. With state budgets already set for the coming year, states are counting on CHIP to continue in its current form. Changes to CHIP’s structure, as mentioned above, would cause significant disruption in children’s coverage and leave states with critical shortfalls in their budgets. If Congress fails to act before week’s end, all states will need to begin preparing to shut down their programs, with some states having to begin shutting down within a few months. They will need to let families know that their children will be disenrolled from coverage and they will be compelled to impose enrollment freezes, barring new applicants from obtaining coverage. Advocates have been voicing the strong and unified message on the need for a five-year extension of CHIP for some time with widely circulated letters, statements and factsheets that make the strong case for a reauthorization.

In order to ensure that children have a healthy start in life, health care must remain affordable, accessible and high-quality for all families with young children, particularly for those facing barriers to health care. Health coverage provides access to a range of essential health care services and supports that promote health and social and emotional development for children and youth. Children with insurance are more likely to have a usual source of care, health care services they need, access to preventive care, and as a result, be better prepared to do well academically and in other aspects of life. As Congress works to reform our nation’s health care systems, it should ensure that health coverage for children is protected and that no child is left worse off. A long-term extension of federal funding for existing CHIP programs is a critical next step. Congress must move quickly to enact a five-year extension of CHIP funding by passing the Keeping Kids Insurance Dependable and Secure Act (S. 1827). Health coverage for millions of children hangs in the balance and there is no time to waste. 

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Shadi Houshyar is a senior associate at CSSP.

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American Community Survey Data Highlight the Experiences of Young Children Living in Poverty http://www.cssp.org/media-center/blog/american-community-survey-data-highlight-the-experiences-of-young-children-living-in-poverty Fri, 15 Sep 2017 14:29:00 -0500 http://www.cssp.org/media-center/blog/american-community-survey-data-highlight-the-experiences-of-young-children-living-in-poverty Earlier this week, the Census Bureau released its official statistics on poverty, income and health insurance coverage in 2016. Following last year’s trend, the data show improvements across all three measures. The average household’s income rose more from 2014 to 2016 than in any other two-year period, and the share of Americans without health insurance fell to a record low of 8.8 percent –  or 28.1 million people – in 2016, demonstrating the positive impact of major health coverage expansions under the Affordable Care Act (ACA). 

The 2016 American Community Survey (ACS), released yesterday, offers a closer look at the economic conditions facing families in cities and counties across the nation and provides greater insight into the experiences of children and families in these communities. Poverty negatively impacts the health and well-being of all individuals, but for a young child, its consequences can shape their entire life trajectory. Early childhood is a critical period for physical, cognitive and social-emotional growth, and creates the foundation for healthy development, academic success and well-being well into adolescence and adulthood. 

CSSP recognizes that public policy can play a significant role in improving the health and well-being of children and families, in particular, families facing the most significant barriers – including living in poverty. To consider the 2016 ACS data in the context of some innovative policy efforts underway across the country, we took a closer look at the data in 3 of CSSP’s EC-LINC network communities and highlighted some of the important work happening in these communities to ensure the health and well-being of young children and their families.

These EC-LINC communities - Los Angeles, CA, Boston, MA and Kent County, MI - are investing in and scaling up effective and innovative strategies for meeting the needs of young children and families. It is important to note that all three of these communities are in states that have expanded Medicaid coverage to adults in poverty – many of them parents. Coverage for parents means that more eligible children will enroll, stay enrolled and receive needed health care, including preventive care. Health coverage provides access to a range of essential health care services and supports that promote health and social and emotional development for children and youth. Children with insurance are more likely to have a usual source of care, health care services they need, access to preventive care, and as a result, be better prepared to do well academically and in other aspects of life. 

Los Angeles, California is home to First 5 LA. In LA County, 10.4 percent of people living in poverty in 2016 were children age 6 and under. Among these children, 75.8 percent were Hispanic or Latino compared to 5.6 percent of their White peers. In LA, 95.3 percent of children age 18 and below living at 138 percent or below of the poverty threshold were covered by some form of health insurance in 2016. 86.5 percent of these children were covered by some form of public insurance. 

There are several efforts underway in Los Angeles to advance the health and well-being of young children in the community. First 5 LA is working to increase family and community protective factors including strengthening families’ capacities, building social connections and concrete supports, promoting family-supporting communities through coordinated services and supports, and creating a common vision and social networks through various investments, including a place-based approach called Best Start in 14 communities. Best Start focuses on building supportive communities where children and families can thrive by bringing together parents and caregivers, residents, businesses and other stakeholders to collectively improve a community’s policies, resources and services to better support residents, and create communities where families can thrive.  

Welcome Baby, a free, voluntary home visiting program that supports pregnant women and new moms through pregnancy and early parenthood is a component of Best Start and is funded by First 5 LA. Welcome Baby started in 2009 as a pilot program and has since expanded to 13 LA County hospitals, serving approximately 60 percent of all families within Best Start communities and over a third of the births countywide. Pregnant women and new moms who deliver or plan to deliver in one of the participating Welcome Baby hospitals are paired with a personal Parental Coach who provides them with information and support during pregnancy and following birth, and if needed, referrals to community resources that help families receive health care coverage or other supportive services. Families enrolled in the program have demonstrated lower parental stress, higher levels of maternal responsiveness and greater communication skills, social competence and engagement compared to non-participating families. 

Boston, Massachusetts is home to the United Way of Massachusetts Bay and Merrimack Valley. In Boston, 9.3 percent of people living in poverty in 2016 were children age 6 and under. Among these children, 51 percent were Black and 36.3 percent were Hispanic or Latino compared to 5.4 percent of White children. In Boston, 98.9 percent of children age 18 and below living at 138 percent or below of the poverty threshold were covered by some form of health insurance. 93.2 percent of these children were covered by some form of public insurance. 

In Boston, there are a number of initiatives underway to help prepare children to enter school ready to learn and develop critical social and academic skills. The United Way is working to ensure all of Boston’s children enter kindergarten ready for success and life through various initiatives including Thrive in 5, a partnership with the City of Boston. Recognizing that developmental screenings, coupled with strong linkages to early intervention services and consistent follow-up can promote well-being and healthy development and help ensure that all young children enter school ready and able to learn, the United Way is incubating the Data & Resources Investing in Vital Early Education (DRIVE), an effort to identify infants, toddlers and preschoolers who are most-at-risk of falling behind and connect them to early intervention services. Data from DRIVE are then used to ensure receipt of timely referrals and early intervention and parent have opportunities to increase their understanding, expectations and involvement in healthy child development. This model has the potential to scale to other cities in Massachusetts. 

Kent County, Michigan is home to First Steps Kent County and the Great Start Collaborative which are focused on ensuring that all children birth to age eight, especially those in highest need, have access to high-quality early learning and development programs and enter kindergarten prepared for success. In Kent County, 11 percent of people living in poverty in 2016 were children age 6 and under. Among these children, 15.9 percent were Black and 49.8 percent were Hispanic or Latino compared to 30.9 percent of White children. 94.1 percent of children age 18 and below living at 138 percent or below of the poverty threshold were covered by some form of health insurance. 89.1 percent of these children were covered by some form of public insurance. 

Committed to ensuring that every young child in Kent County will enter kindergarten healthy and ready to succeed in school and beyond, First Steps Kent County has taken a number of steps to promote positive outcomes for children in the community. These actions include creating the first Kent County Community Plan for Early Childhood, serving as a key player in Michigan's recent 'historic' expansion of the Great Start Readiness Program – a publicly funded preschool program for 4 year olds with factors which may place them at risk of educational failure, and launching multiple demonstration projects including the Children's Healthcare Access Program (CHAP), Early Learning Communities and Welcome Home Baby

CHAP is an evidence-based model that improves the quality of care and health outcomes for children with Medicaid while reducing the cost of care. While originally launched by First Steps, CHAP has since been scaled state-wide to demonstrate that by reallocating resources to focus on prevention and early intervention, the result will be improved health outcomes, higher quality of care and reduced healthcare costs for Michigan’s children. MI-CHAP transforms medical care delivery to the families, providing services throughout the state by utilizing Virtual CHAP (expertly trained CHAP Specialists who are available by calling Michigan 2-1-1 and provide assistance in areas including Medicaid Benefits) and local multidisciplinary teams to increase access to medical homes for children on Medicaid and decrease costs associated with emergency room visits, inpatient hospitalizations and inappropriate asthma management. 

As these examples demonstrate, communities across the country are investing in promising approaches to support families with young children, including home visiting programs, place-based initiatives that help to build communities where children can thrive, and innovations in pediatric care and early learning that focus on early identification and intervention to ensure that children are linked with necessary services and supports and enter school ready and able to learn. While these programs have reached many families, truly scaling such efforts – and better meeting the needs of the millions of children that are experiencing poverty across the country - necessitates policy change.

The ACS data released yesterday make a compelling case for why policy matters and the opportunity policymakers have to improve services and supports for young children and families across the nation. Local data provide important insight into the experiences of children and families living in poverty and highlight how existing supports and services can better meet the needs of every family. To ensure that policies are responsive to the needs of families, policymakers must look at what is happening at the local level and the ACS data provide an opportunity to do that. A look at innovations taking place in these three EC-LINC communities provides promising examples of programs with potential to scale.

Policymakers should use these data to inform action that can be taken now to ensure that children and families have the supports needed to thrive including access to health care, prevention and early learning opportunities. Failure to invest in children and families during early childhood results in inequities that can produce poor and costly outcomes later in life. Policymakers must embrace the challenge of continuing efforts to tackle poverty, inequities and uninsured rates and not leave children and families worse off. In doing so, they should build on our progress in recent years by expanding the innovative efforts underway in communities across the country so that every young child has the opportunities needed to truly thrive.

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Shadi Houshyar is a senior associate at CSSP.

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New Census Data Show Poverty Reduction and Improvements to Economic Security and Family Well-Being, But Highlight the Need for Additional Progress http://www.cssp.org/media-center/blog/new-census-data-statement-2017 Tue, 12 Sep 2017 16:31:00 -0500 http://www.cssp.org/media-center/blog/new-census-data-statement-2017 Today’s release of data by the U. S. Census Bureau on income, poverty and health insurance coverage in 2016 reinforces the crucial role of public policy in mitigating poverty. Despite promising improvements over the past year, the data also revealed an unacceptably high proportion of people (12.7 percent) still living in poverty, with women, children, and people of color experiencing disproportionately higher rates of poverty than their adult, male and non-Hispanic White peers in 2016. Furthermore, almost one in ten people live just above the poverty line and are one crisis away – including a lost job or illness – from falling into poverty. Public policy is an important tool in helping families when they experience a crisis, to support families while they work to provide stability for their children, and to assist families that have been held down by the continued barriers of systemic racism. 

Poverty Highlights 

The 2016 data saw improvements in the number of people living in poverty – 2.5 million fewer people lived in poverty in 2016, down 0.8 percentage points from 2015. However, today’s data also continues to highlight real racial, gender and age disparities in poverty. 

  • 8.8 percent of non- Hispanic Whites and 10.1 percent of Asians lived in poverty in 2016, while Blacks and Hispanics experienced poverty at rates of 22.0 percent and 19.4 percent respectively.
  • In 2016, 14 percent of women lived in poverty compared to 11.3 percent of men. Gender disparities were most pronounced for women ages 18 to 64 with 13.4 percent of women in this age group living in poverty compared to 9.7 percent of men.
  • The poverty rate for families (households – not householder) was 9.8 percent. This rate varied for families with a female head of household (no husband present) at 26.6 percent and for families with a male householder (no wife present) at 13.1 percent.
  • The poverty rate for children in female-headed households was five times the rate for children in married-couple families, at 42.1 percent and 8.4 percent respectively.
  • The poverty rates for Black and Hispanic children, at 30.8 percent and 26.6 percent respectively, were significantly higher than their non-Hispanic White and Asian peers, who faced poverty rates of 10.8 percent and 11.1 percent respectively.

Income Highlights 

The official median income in 2016 saw a statistically significant increase of 3.2 percent from 2015. However clear racial disparities persisted as Black and Hispanic populations continued to face significant income disparities compared with their non-Hispanic White and Asian counterparts[1]. Furthermore, women of color, particularly Black and Hispanic women, continued to face significantly lower earnings than their male counterparts. 

  • The median household income in 2016 was $59,039, a statistically significant change from 2015. 
  • The real median income of non-Hispanic White ($65,041), Black ($39,490), and Hispanic ($47,675) households increased 2.0 percent, 5.7 percent, and 4.3 percent, respectively, between 2015 and 2016.
  • Asian households had the highest real median income ($81,431) in 2016, with no statistically significant percentage change over 2015.
  • In 2016, the median earnings of all women who worked full time, year-round was $41,554 compared to $51,640 for men working full time, year-round.

 Health Insurance Highlights

As in the previous year, the share of Americans lacking health insurance coverage continued to fall to 8.8 percent in 2016 – a historical low that highlights the effectiveness of the Affordable Care Act (ACA) and programs such as the Children’s Health Insurance Program (CHIP), while stressing the need for continued investment in such policies. The 2016 data also demonstrate how these policies work to advance equitable outcomes in that coverage rates for both Black and Hispanic people, as well as low-income people, continued to increase. 

  • In 2016, the rates of private coverage and government coverage continued to increase to 67.5 percent and 37.3 percent respectively.
  • Working-age adults between the ages of 19 and 64 also continued to see coverage gains at 87.9 percent.
  • In 2016, 93.7 percent of non-Hispanic Whites had health insurance coverage compared with 92.4 percent of Asians, 89.5 percent of Blacks and 84.0 percent of Hispanics.
  • In 2016, 94.7 percent of children age 18 and under were covered compared to 88.1 percent of adults, in part due to Medicaid and CHIP which covers children from low-income families.
  • The uninsured rate in 2016 for non-Hispanic White children was 4.1 percent compared to 5.0 percent for Asian children, 5.5 percent for Black children and 7.9 percent of Hispanic children.
  • While the maps below demonstrate the impact of the Affordable Care Act (ACA) in reducing uninsured rates across the country, today’s data further emphasize the impact of Medicaid expansion under the ACA, with expansion states experiencing uninsured rates of almost half those of non-expansion states: 6.5 percent compared to 11.7 percent, respectively.



 The Positive Impact of Policy 

Data from this year’s Supplemental Poverty Measure (SPM) – which takes into account cash income, public benefits and subtracts necessary expenses – continues to demonstrate the important role of public policies in improving the well-being of those facing the greatest barriers to success. While the official poverty measure is based on only pre-tax money income, the SPM also considers the value of in-kind benefits, including the Supplemental Nutrition Assistance Program (SNAP), school lunches, housing assistance and refundable tax credits. Additionally, the supplemental poverty measure deducts necessary expenses for crucial goods and services, including taxes, child care, transportation costs and out-of-pocket medical expenses.

 According to the SPM: 

  • 2016’s supplemental poverty rate was 13.9 percent, not a statistically significant change from 2015.
  • The supplemental poverty rate for children, taking into account tax credits and noncash benefits, was 15.1 percent – a significant decrease than the official child poverty rate of 18.0 percent.
  • As was the case in 2015, the top three federal benefit programs that reduced poverty in 2016 were Social Security, refundable tax credits and SNAP. Each program reduced the supplemental poverty rate by 8.1 percent, 2.5 percent and 1.1 percent, respectively.
  • The greatest increases to the supplemental poverty rate were caused by out-of-pocket medical expenses (3.3 percent) and work expenses (1.8 percent).

     

Policy Matters  

In 2016, 2.5 million people who lived in poverty in 2015 were better off. Policy is critically important for lifting households out of poverty and ensuring that those at greatest risk of slipping into poverty have a strong safety net in times of need. The poverty data released today highlight the clear and positive impact of public policies aimed at strengthening the social safety net. While we continue to see women, children and people of color experiencing disproportionately higher poverty rates and lower incomes when compared to their male or non-Hispanic White counterparts, social safety net programs have provided some of the resources needed to prevent them from falling below or deeper into poverty. Attempts to roll back policies that have been shown to advance well-being outcomes for those living in poverty will undoubtedly reverse the improving trends we’ve seen over the past few years. Pursuing policy strategies that take into account the unique needs of those facing the greatest barriers to success and the existence of disparate opportunities and outcomes is the best way to support those who have been living in and near the poverty level. The data released today by the Census Bureau show the positive impact public investments can have on reducing poverty, improving employment opportunities and ensuring families have health insurance.



[1] It is important to note that studies have found that Hmong Americans have a startlingly high poverty rate at 37.8 percent, followed closely by Cambodian Americans at 29.3 percent and Laotian Americans at 18.5 percent.

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Elimination of the Teen Pregnancy Program (TPP) to Impact the Health and Well-Being of Children, Youth and Families http://www.cssp.org/media-center/blog/elimination-tpp-impact-health-wellbeing-children-youth-families Fri, 11 Aug 2017 13:16:00 -0500 http://www.cssp.org/media-center/blog/elimination-tpp-impact-health-wellbeing-children-youth-families The Teen Pregnancy Prevention (TPP) Program administered through the Department of Health and Human Services, Office of Adolescence was established in 2010 to identify and support diverse organizations working to prevent teen pregnancy across the United States. Its purpose was to develop and identify evidence-based programs aimed at promoting healthy choices and well-being in youth. The program also sought to inform future practice through ongoing program evaluations. 

Organizations receiving TPP program funds serve youth in communities, juvenile detention facilities, foster care and schools through government agencies, tribal organizations, non-profits and religious organizations. TPP Program grantees provide participating youth with comprehensive reproductive health education and focus on strategies to resist peer pressure and mitigate intimate-partner violence in addition to building healthy relationships with parents and providing career planning services.

From 2010 to 2014, 102 organizations were awarded five year TPP grants, serving over 500,000 youth nationally. Over the course of these five years, 41 independent evaluations were conducted that provided significant insight for the youth services field on the most effective programs. Through independent evaluations, the work of these organizations increased programmatic knowledge of effective prevention programming for youth that has helped move the field forward. Using the knowledge generated from these evaluations and the experiences of these agencies, the second round of TPP awards were made to build on the work from the first cohort and support replication of evidence-based programs. Grants were awarded to organizations that implemented evidence-based teen pregnancy prevention programs, built the capacity of youth-serving organizations and developed technology-based and other innovative youth-informed programs. 

In order to ensure positive outcomes for youth, including avoiding unsafe sexual behaviors, it is important that policies focus on – and funding be invested in – programs with a proven track record in increasing access to high-quality, comprehensive services that meet the needs of youth. The TPP Program does just that, however in late June 2017, the current Administration – which favors abstinence-only policies – quietly cut the program, eliminating $213.6 million in funding for organizations combating teen pregnancy.

Teen pregnancy has been declining since 2007. Between 2010 and 2014 (during the first cohort of TPP grantees), we saw the national teen pregnancy rate drop by 29 percent. While this is important progress, teen pregnancy still remains relatively high – particularly for young people facing additional risk-factors. Adolescents who live in poverty, grow up in a single parent household or are in foster care are at an increased risk of having an unplanned pregnancy. Further, Hispanic and Black adolescents, who experience these risk factors at disproportionate rates, are twice as likely as their white peers to experience pregnancy by the age of 19. TPP grantees have worked to reduce these disparities by targeting their efforts to these most at-risk youth and by tailoring their programming to address specific community needs.   

This funding cut and other similar efforts ignore the positive impacts that these public and community based programs provide to the health and well-being of youth. We know that the promotion of healthy development, strong social connections and concrete supports increases positive outcomes for youth and their families. The elimination of the TTP Program showcases the Administration’s disregard for programming proven to reduce teen pregnancy and for investing in the health and well-being of our country’s children, youth and families. CSSP recognizes that healthy development and well-being in youth depend on their ability to postpone starting a family of their own until they are emotionally and financially prepared for the responsibilities that come with parenting. Eliminating support for programs that seek to give youth the information and resources they need to make informed decisions about their life runs counter to best practice, existing research and common sense. We call on advocates, communities and states to continue to invest in programs that we know work, promote healthy development in youth and support youth to thrive.


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Alexis Grinstead is a policy analyst at CSSP.

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New Brief Identifies and Supports LGBTQ Youth who have Experienced Sexual Exploitation http://www.cssp.org/media-center/blog/new-brief-identifes-and-supports-lgbtq-youth-who-have-experienced-sexual-exploitation Wed, 26 Jul 2017 16:00:00 -0500 http://www.cssp.org/media-center/blog/new-brief-identifes-and-supports-lgbtq-youth-who-have-experienced-sexual-exploitation Healthy relationships are important for the positive development of children and youth, and are especially important for lesbian, gay, bisexual, transgender or queer (LGBTQ) youth of color in child welfare. LGBTQ youth are disproportionately represented in the child welfare system and within that demographic, youth of color are particularly disproportionately represented. According to the National Survey of Child and Adolescent Well-Being – II, 61.8 percent of LGB children in child welfare are youth of color. Not only do LGBTQ youth of color experience disproportionate representation in the child welfare system, when systems fail to meet their needs they are also at a “heightened risk of exploitation due to experiences including rejection and desperate need of shelter, food and other necessities”.

The importance of healthy relationships for youth was apparent in CSSP-led focus groups, where youth spoke of experiences with healthy and unhealthy relationships, including sexual exploitation, and the response (or lack thereof) by child welfare systems. One barrier youth identified was the inaccessible language used by systems to identify and document these experiences, including the use of terms like sex trafficking or commercial sexual activity in assessments and intake forms. In order for child welfare systems to be able to identify and serve youth who have experienced sexual exploitation, it is important to use language that resonates with and matches the lived experiences of youth and to work with young people to identify healthy relationship patterns.

Often, young people involved in sexual exploitation are unaware of the exploitative nature of their relationships. For example, a young person might perceive the exchange or expectation of sex in return for basic needs such as food or shelter as a normal part of an intimate relationship. Youth also cite fear of punishment and resulting stigma as to why they are hesitant to identify their experiences as sexual exploitation to adults and systems professionals. In addition, implicit bias on behalf of workers and perceptions of promiscuity or perceptions that youth of color are older and less innocent than their white peers may affect how assessment tools are applied for LGBTQ youth of color. Consequently, when the language systems use around sex trafficking and exploitation at intake and in assessments does not match the experiences of LGBTQ youth of color in the child welfare system, both systems and young people themselves may be prevented from accurately identifying those who have experienced sexual exploitation. This lapse between language and lived experience in turn also prevents the system from connecting these youth with appropriate supports and services.

In 2014, President Obama signed the Preventing Sex Trafficking and Strengthening Families Act (H.R. 4980) into law which requires child welfare agencies to identify, report and support youth who are either at risk or have been victims of sex trafficking. Our focus groups and interviews concluded that in order to fully meet this requirement, the language utilized by the child welfare system must enable and support youth and fully engage LGBTQ youth of color.

Our recent brief, Bridging the Language Gap in Child Welfare: Identifying and Supporting LGBTQ Youth who have Experienced Sexual Exploitation, recommends ways for systems to support the identification of LGBTQ youth of color who have experienced sexual exploitation. States should:

  • Ensure youth engagement in the design and implementation of improved screening tools to increase capacity for child welfare systems to identify youth involved with sexual exploitation and trafficking;
  • Utilize multidisciplinary teams to ensure consistent language and definitions across systems;
  • Eliminate barriers to accessing child welfare services by updating and clarifying key definitions and terminology; and
  • Raise the minimum age from 18 to 21 years old for instances of sex trafficking that must demonstrate force, fraud or coercion.

These four recommendations aim to remove barriers to identifying LGBTQ youth who have experienced sexual exploitation. Identifying youth is the first step to connecting them with the appropriate and necessary supports and services. If child welfare systems are not able to identify youth, then they will not be able to provide supports and services that address unhealthy relationships and strengthen healthy relationships for LGBTQ youth of color.

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Justine Kim is a communications intern at CSSP. She is currently an undergraduate at Northwestern University, majoring in social policy and Asian American studies. 

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Texas Religious Exemption Bill to Target LGBTQ Youth and Families http://www.cssp.org/media-center/blog/texas-religious-exemption-bill-to-target-lgbt-youth-and-families Wed, 31 May 2017 13:48:00 -0500 http://www.cssp.org/media-center/blog/texas-religious-exemption-bill-to-target-lgbt-youth-and-families The Texas “Freedom to Serve Children Act”, passed by the Texas Senate on May 22 and sent to Governor Abbot for approval, allows publicly-funded foster care and adoption agencies to refuse to place children with non-Christian, unmarried or gay prospective parents due to religious objections. This legislation, along with a similar bill passed in South Dakota in March, rather than protecting children in foster care puts first the needs and wants of a specific group of adults and undermines the safety and well-being of all children involved in the child welfare system. This legislation specifically targets lesbian, gay, bisexual, transgender, queer (LGBTQ) and gender expansive communities as well as prospective foster and adoptive parents who are single parents, non-Christian couples such as Jews, Muslims and interfaith couples.

When children and youth enter the child welfare system, the state child welfare agency has a responsibility to ensure that they are safe, placed in the least-restrictive, most family-like settings possible and supported in their development and well-being. When children and youth cannot reunify with their parent(s), all efforts are to be made to find and support a positive permanent relationship with another parent or caregiver. Already, child welfare systems across the country struggle to identify and maintain enough loving and supportive foster and adoptive homes and each year more than 20,000 young people “age-out” of foster care without ever being placed in a family or permanent home. Allowing publicly-funded agencies to prevent safe, loving and caring individuals and families from becoming foster and adoptive parents directly contradicts the mandates of the child welfare system and will have very real and harmful effects on all children in the child welfare system.

Further, we know that LGBTQ and gender expansive youth are overrepresented in the child welfare system and are disproportionally youth of color.  Many of these youth have entered foster care because they were rejected by their families due to their sexual orientation or gender identity. This legislation sends a clear and powerful message that the public agencies charged with protecting youth who have been rejected by their families will further repeat that trauma and validate such rejection by not supporting or affirming their identities. This rejection and additional traumatization directly contradicts all that we know is considered good parenting, including the results of scientific studies showing that children raised by same sex couples experience healthy outcomes. It also discounts the fact that foster and adoptive parents of all religions have demonstrated the ability and commitment to provide loving and affirming homes to all children regardless of their religious affiliation.

Research shows that young people who identify as LGBTQ or who are gender expansive are more likely than their heterosexual, cisgender peers to experience multiple foster placements, be moved from their first placement at the request of the caregiver or foster family and be placed in congregate care settings. As many as one out of every four LGBTQ youth in a congregate care setting will exit care without achieving permanency. Young people who age out of care without achieving positive permanency are more likely to experience housing instability and homelessness, face poor educational outcomes and become involved with the criminal justice system. The cost to our families, communities and our country continue to mount with this kind of discriminatory legislation.

These outcomes are far from inevitable and many states and communities are moving forward to explicitly affirm and support LGBTQ and gender expansive families, youth and communities. To thrive, we know that all young people involved in child welfare need:

  1. safe and affirming placements in the most family-like settings possible
  2. safe schools and communities
  3.  appropriate medical and behavioral health care
  4. connections to family and supportive social networks;
  5.  external connections and support transitioning from care; and
  6.  connections to aftercare services.

Across the country, many communities, schools and allies, including those with deeply held religious beliefs are putting in place policies and practices that affirm and support LGBTQ and gender expansive children, youth and families. In addition to the 19 states and many local jurisdictions that have non-discrimination policies that include and protect LGBTQ and gender expansive youth, we have seen many recent positive pieces of state legislation:

  • Connecticut House Bill 6695, signed into law in May, 2017, bans conversion therapy
  • Illinois enacted enhanced Department of Children and Family Services procedures in May, 2017 that increase mandatory training for anyone working with LGBTQ youth and clarifies protections for transgender and gender expansive children in care
  • Nevada AB99, which was signed into law in April 2017, mandates training for working with LGBTQ youth, respecting a young person’s gender identity and placing LGBTQ and gender expansive young people in accepting homes

Policy makers, child welfare system leaders and practitioners must remain committed to their mission and mandate to achieve permanence, safety and well-being for all system-involved children and continue to advocate against discriminatory legislative proposals. Promoting safety and affirmation is critical to ensuring healthy identity development and positive outcomes for LGBTQ and gender expansive young people. We must ensure that all young people involved in child welfare are recognized, engaged, affirmed and loved to achieve well-being. This is best achieved through their in permanent loving, affirming families that we know exist across all faiths, sexual orientations, gender identities and family configurations.

This legislation and other similar efforts, such as the rescindment of federal guidance supporting transgender youth’s safety and well-being in school settings, undermine the safety and well-being of LGBTQ and gender expansive communities. CSSP promotes promising policies and practices that support the well-being of all children, youth and families. This legislation and similar proposals affirmatively hurts children, youth and families and runs counter to evidence and best practice in the field.  We call upon advocates and policymakers across the country to proactively work to protect all children and youth in foster care and reject such legislation and any other similar efforts.

For more information about policies that support LGBTQ and gender expansive youth in child welfare, please see our recent report, “Out of the Shadows: Supporting LGBTQ Youth in Child Welfare through Cross-System Collaboration.”

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Rosalynd Erney is a policy analyst at CSSP.

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New Resource: Youth Thrive™ Tip Sheet for Family Court Partners http://www.cssp.org/media-center/blog/new-resource-youth-thrive-tip-sheet-family-court-partners Wed, 31 May 2017 12:00:00 -0500 http://www.cssp.org/media-center/blog/new-resource-youth-thrive-tip-sheet-family-court-partners In 2011, in response to the troubling outcomes of young people in and exiting foster care, the Center for the Study of Social Policy (CSSP) assembled recent research on resilience, positive youth development, neuroscience and trauma to examine how all youth, and specifically youth involved in public systems such as child welfare and juvenile justice, can be supported in ways that advance healthy development and build upon young people’s strengths. The result is a framework called Youth Thrive™, which identifies five protective and promotive factors that help mitigate risk and build youth well-being. The Youth Thrive™ framework is currently implemented in seven states and jurisdictions across the country. These child welfare and juvenile justice public agencies have adopted the Youth Thrive™ Framework and are using it as a lens to revise their policies and programming. For more information on the Youth Thrive™ protective and promotive factors, please visit: http://www.cssp.org/reform/child-welfare/youththrive

Recently, CSSP received requests from judges and other court partners to develop a guide on how to use the framework in the context of family court proceedings. The Youth Thrive™ Tip Sheet for Family Court Partners is designed to guide conversations about the five protective and promotive factors among partners in preparation for and during family court proceedings. It provides an introductory summary to the Youth Thrive™ framework for judges, guardians ad litem, lawyers, parents, CASA workers, agency workers and youth. The purpose of the tip sheets, which are divided by role, is to actively promote the building of the Youth Thrive™ protective and promotive factors by providing sample questions that can be posed to youth, parents, professionals and other colleagues to ensure that young people receive the services and opportunities they need to thrive.

Read and download the tip sheet here.

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Martha Raimon is a senior associate at CSSP.

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In the Footsteps of Giants http://www.cssp.org/media-center/blog/in-the-footsteps-of-giants Tue, 30 May 2017 11:27:00 -0500 http://www.cssp.org/media-center/blog/in-the-footsteps-of-giants Each of us is the product of our own experiences, and those who molded our personal and professional lives. This Memorial Day weekend, I found myself in the midst of encounters with my own role models in pediatrics. On Sunday, I saw T. Berry Brazelton, the kind and brilliant pediatrician whose books captured the imagination of parents in the late 20th century. Although he is now 99 years old, Berry walked in with a huge smile on his face, and promptly engaged in conversation with an eleven-year-old girl who wants to become a pediatrician.

Later this week, I will head up to Vermont for a celebration of the life of Paula Duncan, the guiding force (and I do mean force) behind the movement in pediatrics to move beyond screening for risk to assessing the positive in children and families, and partnering with parents to grow these assets.

These two leading lights amplify the themes that children need more than protection from adversity, they also need safe places to live, learn and play and to experience connection and support from the adults and peers who shape their worlds.

With the support of Casey Family Programs, I led a group of early childhood experts to produce a new report, Balancing Adverse Childhood Experiences with HOPE (Health Outcomes of Positive Experiences). This report pulls together results from four separate population surveys. We learned that adults who recalled warm, nurturing relationships with their families and communities became healthier adults, even if they had multiple adversities in childhood.

While policymakers struggle to improve screening for risk and adversity, US parents and other adults already get it: children’s brains grow and develop in response to all their experiences, both adverse and positive. According to a 2016 population survey conducted by yougov.com and reported for the first time in the HOPE report, there is wide consensus among American adults of all ethnicities about the importance of positive parenting practices, and the political will to move forward in supporting families.

HOPE complements other new approaches to supporting child development and preventing abuse and neglect. Looked at through the lens of the social-ecological model, they all fit: The CDC advocates policies that support families through its Essentials for Childhood initiative. CSSP’s Strengthening Families approach emphasizes the centrality of the family in the lives of children, and articulates a set of protective factors that families need to thrive. HOPE completes this triad by demonstrating that protective factors operate through affecting children’s experiences.

The HOPE report provides more data and background for an approach that balances concerns about trauma and adversity with one that promotes the development of healthy resilient children who have had the positive experiences we all need. Although the report and the information within it is new, my own relationships with my mentors – Paula Duncan and T. Berry Brazelton – remind me that we are in fact only adding to a solid foundation of understanding.

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Dr. Robert Sege, MD, PhD, FAAP, is a practicing pediatrician, the Chief Medical Officer at Health Resources in Action, and a Senior Fellow at CSSP. 

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CSSP Welcomes Health Policy Expert to Young Children and their Families Team http://www.cssp.org/media-center/blog/cssp-welcomes-health-policy-expert-to-young-children-and-their-families-team Fri, 26 May 2017 12:00:00 -0500 http://www.cssp.org/media-center/blog/cssp-welcomes-health-policy-expert-to-young-children-and-their-families-team The Center for the Study of Social Policy (CSSP) is excited to welcome Donna Cohen Ross as Associate Director, with responsibility for leading CSSP’s work related to Young Children and their Families. Donna has devoted her career to reducing poverty and improving access to public benefits for low-income children and families.

“Donna brings a wealth of experience and skills to CSSP, with depth in health policy finance, leading national policy campaigns, taking work to scale and bridging the worlds of health, early learning and nutrition,” said Frank Farrow, CSSP’s Director.

“Donna brings a wealth of experience and skills to CSSP, with depth in health policy finance, leading national policy campaigns, taking work to scale and bridging the worlds of health, early learning and nutrition,” said Frank Farrow, CSSP’s Director.

Donna comes to CSSP from Health Management Associates, where she focused on helping children’s programs — including maternal and child home visiting, early literacy and pediatric care programs — obtain support from Medicaid. From 2010 to 2015, Donna served as a Senior Policy Advisor and the Director of Enrollment Initiatives in the Center for Medicaid and CHIP Services (CMCS) at the U.S. Dept. of Health and Human Services. There she crafted guidance that helped jump-start Medicaid enrollment under the Affordable Care Act for individuals participating in the SNAP Program. She also directed Connecting Kids to Coverage, the first-ever federal outreach campaign to find and enroll children eligible for Medicaid and CHIP. Prior to that experience, Donna led the outreach division at the Center for Budget and Policy Priorities for 17 years.

Donna also brings to CSSP a background in other issues of importance to children and families, having worked early in her career with the Association for Children of New Jersey, the Community Food Bank of New Jersey and the Newark Preschool Council.

As Donna joins the Center, Amy Fine, who previously led the Young Children and their Families team, will continue to move CSSP’s work forward as a Senior Fellow based in San Francisco.  She will focus on CSSP’s work in California and on new initiatives across the organization.

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Viet Tran is a communications mananger at CSSP. 

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Congressional Budget Office Report Says American Health Care Act Jeopardizes Recent Gains Made in Health Care Coverage http://www.cssp.org/media-center/blog/congressional-budget-office-report-ahca-jeopardizes-gains-health-care-coverage Thu, 25 May 2017 12:26:00 -0500 http://www.cssp.org/media-center/blog/congressional-budget-office-report-ahca-jeopardizes-gains-health-care-coverage The Congressional Budget Office’s (CBO) report on the House-passed version of the American Health Care Act (AHCA), released on May 24, 2017, highlights the ways in which the bill jeopardizes recent gains made in health care coverage, which is a foundation for healthy development and well-being. As CSSP mentioned in a previous blog post, American Health Care Act (AHCA) Passes the House: A Significant Step-back in Health Care Coverage and Advancement in Health Equity, on May 4, 2017, the House voted along party lines to pass the American Health Care Act (AHCA), by a narrow margin of 217 – 213, before the amended bill had the opportunity to be scored by the Congressional Budget Office (CBO). In order to garner enough votes amongst House Republicans, the bill included an amendment crafted by Representatives Mark Meadows (R - NC) of the conservative Freedom Caucus and Tom MacArthur (R - NJ) of the moderate Tuesday Group allowing states to request waivers of essential health benefits and of “community rating” requirements. These harmful waivers would enable insurance providers to: 

  • roll back nationwide standards that require plans to cover services like emergency services, mental health and substance use treatment
  • discriminate against individuals based on their medical history by increasing their insurance premiums;
  • charge women more than men for health coverage as they would have to pay more for plans that include maternity coverage; and
  • re-impose annual and lifetime limits on coverage. 

The CBO report estimates that the bill would lead to the loss of coverage for approximately 23 million people by 2026 – disproportionately impacting children and families of color, low-income children and families and those facing significant barriers to coverage such as those with pre-existing conditions and those who use mental health services or are in need of substance use treatment.

The CBO report estimates that the bill would lead to the loss of coverage for approximately 23 million people by 2026 – disproportionately impacting children and families of color, low-income children and families and those facing significant barriers to coverage such as those with pre-existing conditions and those who use mental health services or are in need of substance use treatment. The AHCA would also effectively end the Medicaid expansion (currently in effect in 31 states and Washington D.C.) as well as reduce individuals’ and families’ access to health care services, weakening coverage or making it less affordable. As amended, the AHCA would allow insurance providers to exclude basic services such as maternity coverage, substance use or mental health treatment or prescription drugs, leaving many people with pre-existing conditions unable to find the coverage they need at any price. Specifically, the CBO report estimates extremely high premiums for those with pre-existing conditions - essentially creating yet another barrier for these individuals to access necessary health care services. The $8 billion (along with a required state contribution) set aside in the bill to help cover those who fall into a high-risk pool also falls significantly short of eliminating the bill’s funding deficits or solving the other problems it creates for people with pre-existing conditions. 

Changes to Medicaid would also devastate state budgets, forcing them to cover the $834 billion spending gap or make difficult decisions regarding who qualifies for the program – potentially pitting vulnerable groups against each other. These changes will also reduce child welfare, juvenile justice and education spending and services – all of which now effectively leverage Medicaid dollars to promote healthy development and well-being for children and youth. Specifically, the AHCA: 

  • Ends federal match funding for all who qualify for Medicaid – effectively converting Medicaid from an open-ended entitlement program to a block grant or per-capita cap;
  • Does not allow states to expand Medicaid coverage to uninsured adults after 2018;
  • Allows states to determine what qualifies as an “essential health benefit;" and 
  • Increases premiums for individuals based on breaks in coverage.  

Currently, ninety-five percent of children in the United States have health coverage – a historic high – thanks in large part to the Affordable Care Act (ACA), Medicaid and the Children’s Health Insurance Program (CHIP). More than 11 million low income adults are also benefitting from expanded Medicaid under the ACA. This progress is threatened however, by continued attempts to dismantle the current structure of providing health care to Americans through efforts such as the AHCA and President Trump’s FY 2018 budget proposal (released yesterday), which includes an additional $616 billion cut to the Medicaid program and CHIP. 

When parents are able to access health care coverage and treatment, it not only strengthens their capacity to promote their child’s development, but increases rates of coverage and treatment services for their children. Legislators have the ability to promote positive health and well-being outcomes for children, families and communities in an equitable manner. But by failing to meaningfully invest in policies and programs that have the ability to reduce systemic barriers to success, they instead create disparate outcomes for children, families and communities of color. As the Senate considers this piece of legislation within the coming month, CSSP urges legislators to reject this harmful proposal and any other damaging attempt to dismantle the current structure of providing health care to Americans. 

For more information on how the current structure of Medicaid promotes well-being and healthy outcomes for children and families and the dangers of altering the funding structure of the program, download and read recent CSSP briefs: 

We will continue to issue policy briefs, statements and blogs in response to attacks on equity, basic rights and well-being. These are continually evolving issues, and our analysis and specific recommendations will change as we learn new information. Please continue to follow us on social media (@CtrSocialPolicy and fb.com/ctrsocialpolicy) and visit our website at www.cssp.org

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Rhiannon Reeves is a policy analyst at CSSP.

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President's Budget Will Harm Families' Health and Increase Inequities http://www.cssp.org/media-center/blog/presidents-budget-will-harm-families-health-and-increase-inequities Tue, 23 May 2017 16:37:00 -0500 http://www.cssp.org/media-center/blog/presidents-budget-will-harm-families-health-and-increase-inequities As details about the President’s proposed Fiscal Year (FY 2018) budget have emerged, concerns about how the needs of families – particularly those facing the greatest barriers to opportunity – will be met in an equitable and effective manner have intensified. When the President’s proposed “skinny” budget was released in March with limited details, it was clear that the health and well-being of children and families were at-risk. Now, the full version of the proposed budget, “A New Foundation for American Greatness,” makes it even more apparent that the cuts proposed by the President would increase the challenges facing families who experience poverty, food insecurity, homelessness and other forms of compounding disadvantage – disproportionately children and families of color. 

The President’s proposed budget ignores key opportunities to advance equity and instead dramatically cuts – or eliminates entirely – funding for a number of essential safety net programs. All Americans lose in this budget proposal – only a small handful of wealthy households would stand to gain – but the budget is merciless in its treatment of low-income families. Overall, $1.7 trillion would be cut from mandatory domestic spending over 10 years. These devastating cuts are directed at programs that are vital pieces of the social safety net for families with low incomes, including $616 billion from Medicaid and the Children’s Health Insurance Program (CHIP), $21 billion from Temporary Assistance to Needy Families (TANF), $40 billion from the Earned Income Tax Credit (EITC) and Child Tax Credit, $72 billion from programs that support people with disabilities, and $193 billion from the Supplemental Nutrition Assistance Program (SNAP). These programs provide crucial supports to families seeking pathways out of poverty and can mitigate the effects of poverty on children and youth as they grow and develop. The proposed cuts are targeted directly at families experiencing poverty, families of color and immigrant families, moving the budget in a direction that worsens inequities.

The threats posed to families by the President’s dangerous proposals are significant and far-reaching. Specifically, cuts to Medicaid, CHIP and SNAP will negatively impact the health and well-being of children and families and signal l a clear attack by the Administration on children and families, reducing access to and affordability of critical health services, increasing food insecurity and ultimately contributing to poorer outcomes for families. These cuts are particularly significant for children and families of color who, due to compounding effects of disadvantage, face greater threats to their health than white children and families.

Cuts to Medicaid: The President’s devastating proposal to eliminate $610 billion from Medicaid over the next 10 years – in addition to the estimated $800 billion that would be eliminated from the program under the American Health Care Act (AHCA) – would shred an integral piece of America’s health care safety net. Medicaid serves as the primary source of health insurance for Americans with low-incomes, covering nearly 70 million people, over half of whom are children. The Affordable Care Act (ACA) expanded access to Medicaid to nonelderly adults with low-incomes, further improving health care access and affordability for families experiencing poverty in the 31 states and District of Columbia that implemented this option.

Medicaid access has been particularly important for children of color given that it has, in coordination with CHIP, covered 54 percent of black children and 52 percent of Hispanic children in 2014, as well as 25 percent of Asian children and 26 percent of white children. Medicaid has reduced racial and ethnic disparities in access to primary and preventive care, which is crucial to closing gaps in health and developmental outcomes for children of color.

Medicaid has reduced racial and ethnic disparities in access to primary and preventive care, which is crucial to closing gaps in health and developmental outcomes for children of color.

The proposed Medicaid cuts would also be disastrous for children and families involved with child welfare systems, who depend on health care coverage and access to supports and services funded through Medicaid. A strong Medicaid program is critical for these young people as children and youth placed in foster care typically have more complex health care needs than their non-foster care peers.

Cuts to CHIP: The President proposes reducing funding for the Children’s Health Insurance Program (CHIP) – which insures 5.6 million children – by at least 20 percent over the next two fiscal years, directly impacting the health of children across the country. Cuts would be achieved by eliminating an element of the ACA that increased by 23 percent the portion of the program’s costs that is paid for with federal money. This would greatly increase the burden upon states to fund CHIP at the same time that they are also being asked to pick up a greater portion of the costs for SNAP and Medicaid. Currently CHIP and Medicaid work together to ensure that children receive the health care they need, promoting healthy development. CHIP also effectively reduces disparities in coverage and health outcomes for young children of color.

The budget proposal would add additional eligibility restrictions to CHIP, creating a coverage gap for families with slightly higher incomes who nevertheless may not be able to afford health coverage for their children, particularly in high-cost regions. Federal funding would no longer be available to help cover children from families with incomes of more than 250 percent of the federal poverty level. Currently, 18 states and the District of Columbia allow families with incomes higher than 300 percent of the poverty line to access CHIP, according to data from the Kaiser Family Foundation. These families would all be at risk of losing health care coverage for their children, including access to preventive care.

Cuts to SNAP: The President’s proposed $193 billion reduction in spending for SNAP – equal to more than 25 percent of the program’s budget – will lead to higher rates of hunger and food insecurity, and poorer health for children and families. Food insecurity, or a lack of consistent access to enough, nutritious food, is a serious threat to the health and well-being of over 42 million people across the country and disproportionately affects families of color, households headed by a single woman,  households with young children and those who identify as LGBT. SNAP is currently serves one of the nation’s most effective public health and anti-poverty tools, offering nutrition assistance to 42 million families of every description.

The President’s budget would restrict eligibility for the program, impose work requirements beyond those already in place, and requiring states to begin matching 25 percent of the benefits their residents receive by 2023. SNAP has been an effective program for decades because of its flexible structure as a federally-funded entitlement that allows SNAP to respond to sudden changes in need, including spikes in unemployment and natural disasters. Shifting cost burdens to the states will dissuade states from ensuring all families who need SNAP benefits receive them. Furthermore, the U.S. Department of Agriculture reports that only about 14 percent of SNAP participants who are assumed to be able to work are unemployed, making the imposition of additional, redundant work requirements unnecessary, ineffective and burdensome for states to implement. The ultimate impact of these additional restrictions will be to discourage eligible households from participating in SNAP when they experience food insecurity, to the detriment of the health and well-being of children, youth and families across the nation.

SNAP has been an effective program for decades because of its flexible structure as a federally-funded entitlement that allows SNAP to respond to sudden changes in need, including spikes in unemployment and natural disasters.

Nutrition supports are also critical for youth who are seeking to gain stability as they move into adulthood, including youth aging out of foster care, who are significantly more likely to experience poverty, homelessness and food insecurity as they transition into adulthood without the same degree of support from family members that many of their peers have. Food insecurity at these pivotal points can contribute to poorer outcomes in health and education for young children and youth. Because food insecurity disproportionately impacts families of color, reducing federal supports for families experiencing food insecurity will also ultimately deepen inequity across the nation.

Conclusion

The President’s proposed FY 2018 budget is alarming in its disregard for the struggles of our country’s low-income families, and will likely lead to greater disparities for children and families of color. The proposed budget offers important insight into the Administration’s policy priorities signaling a lack of concern with the health and well-being of children and families and a disregard for equity. CSSP is redoubling its commitment to meeting the needs of families facing the most significant barriers, including families of color and others who on a daily basis experience inequitable access to opportunities for health and economic stability.  We will continue to monitor appropriations activities, uplift any negative impacts on children and families, and bring to light the ripple effects federal budget proposals will have in state and local budgets.

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American Health Care Act (AHCA) Passes the House: A Significant Step-back in Health Care Coverage and Advancement in Health Equity http://www.cssp.org/media-center/blog/american-health-care-act-ahca-passes-the-house-a-significant-step-back-in-health-care-coverage-and-advancement-in-health-equity Thu, 04 May 2017 15:29:00 -0500 http://www.cssp.org/media-center/blog/american-health-care-act-ahca-passes-the-house-a-significant-step-back-in-health-care-coverage-and-advancement-in-health-equity Today, the House voted to pass the American Health Care Act (AHCA) – including an amendment crafted by Representatives Mark Meadows (R - NC) and Tom MacArthur (R - NJ) – representing continued efforts to dismantle the current structure of providing health care to Americans. The AHCA is a significant step back and jeopardizes recent gains made in health care coverage, which is a foundation for healthy development and well-being. The AHCA’s changes will reduce individuals’ and families’ access to health care services, weakening coverage or making it less affordable. Its changes to Medicaid will also devastate state budgets, reducing child welfare, juvenile justice and education spending and services – all of which now effectively leverage Medicaid dollars to promote healthy development and well-being for children and youth. Specifically, the AHCA:

  • Ends federal match funding for all who qualify for Medicaid – effectively converting Medicaid from an open-ended entitlement program to a block grant or per-capita cap;
  • Does not allow states to expand Medicaid coverage to uninsured adults after 2018;
  • Allows states to determine what qualifies as an “essential health benefit;" and 
  • Increases premiums for individuals based on breaks in coverage. 

Based on the Congressional Budget Office report on the initial version of the AHCA, provisions included will lead to the loss of coverage for approximately 24 million people and disproportionately impact children and families of color, low-income children and families and those facing significant barriers to coverage such as those with pre-existing conditions and those who use mental health services or are in need of substance use treatment. 

In order to garner the necessary votes, the AHCA now includes the Meadows-MacArthur amendment, which builds on an already harmful bill by allowing states to request waivers of essential health benefits and of “community rating” requirements. These waivers would enable insurance providers to:

  • roll back nationwide standards that require plans to cover services like emergency services, mental health and substance use treatment
  • discriminate against individuals based on their medical history by increasing their insurance premiums;
  • charge women more than men for health coverage as they would have to pay more for plans that include maternity coverage; and
  • re-impose annual and lifetime limits on coverage.

While the AHCA now includes $8 billion in federal funding to help cover those who fall into a high-risk pool and requires states to set up their own funding for these individuals, it falls significantly short of eliminating the bill’s funding deficits, or solving the other problems it creates for people with pre-existing conditions. 

Currently, ninety-five percent of children in the United States have health coverage – a historic high – thanks in large part to the Affordable Care Act (ACA), Medicaid and the Children’s Health Insurance Program (CHIP). More than 11 million low income adults in 31 states and the District of Columbia are also benefitting from expanded Medicaid under the ACA. When parents are able to access health care coverage and treatment, it not only strengthens their capacity to promote their child’s development, but increases rates of coverage and treatment services for their children. The AHCA now goes to the Senate where it could face barriers to passage. 

For more information on how the current structure of Medicaid promotes well-being and healthy outcomes for children and families and the dangers of altering the funding structure of the program, download and read recent CSSP briefs:

Today’s vote in the House along with the Executive Order Promoting Free Speech and Religious Liberty, which addresses amending regulations to allow for organizations to not provide preventive care based on a religious objection, marks a significant step backward in health care coverage for all Americans. We will continue to issue policy briefs, statements and blogs in response to attacks on equity, basic rights and well-being. These are continually evolving issues, and our analysis and specific recommendations will change as we learn new information. Please continue to follow us on social media (@CtrSocialPolicy and fb.com/ctrsocialpolicy) and visit our website at www.cssp.org

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Rhiannon Reeves is a policy analyst at CSSP.

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CSSP Releases Building Neighborhood Capacity Program Practice Brief Series http://www.cssp.org/media-center/blog/cssp-releases-building-neighborhood-capacity-program-practice-brief-series Sat, 29 Apr 2017 12:00:00 -0500 http://www.cssp.org/media-center/blog/cssp-releases-building-neighborhood-capacity-program-practice-brief-series Concluding its role as technical assistance provider for the Building Neighborhood Capacity Program (BNCP), the Center for the Study of Social Policy is releasing a four-part series of practice briefs reflecting on program learnings. Highlighting guidance and examples from the four BNCP sites in Flint, MI; Fresno, CA; Memphis, TN; and Milwaukee, WI; the briefs focus on:

Launched in 2012 by the Obama Administration, BNCP aimed to catalyze community-driven change in neighborhoods that have historically faced barriers to revitalization. The program focused on building the capacity of residents, community organizations, and city-level stakeholders to work together to make progress on neighborhood priorities. BNCP was supported by a federal interagency partnership, with funding from the U.S. Departments of Justice, Education, and Housing and Urban Development, and additional partnership from the Department of Health and Human Services.

The first two BNCP practice briefs, originally released in September 2016, discuss the program’s focus on engaging residents and partners to develop local knowledge to inform results-focused revitalization strategies. Exemplifying an action-learning approach to capacity building, sites were encouraged to conduct “learn-by-doing” projects that provided an opportunity for participants to make a difference in the community while developing knowledge, skills, and relationships that could be applied to longer-term planning and revitalization efforts.

The second two practice briefs discuss what it takes to advance community-driven priorities in neighborhoods that have been historically disconnected from resources and power. The briefs underscore that differences in outcomes rooted in place are closely tied to generations of racial and economic segregation that have limited where people can live and work. As described in the third brief, bringing together people to tackle these disparities requires engaging residents and partners to communicate and collaborate across differences in race, class, and power. The fourth brief takes an in-depth look at efforts to transform relationships between neighborhoods and citywide leaders in particular, focusing on how the cities of Fresno and Memphis approached aligning resources, increasing investments, and changing practice or policy to respond effectively to the aspirations of BNCP neighborhoods. 

While federal funding for BNCP has concluded, local teams in each city are working to build on the foundation of progress to date. In doing so, they seek to sustain a focus on working across neighborhood and city boundaries, while engaging residents and partners to apply ongoing capacity gained to propel the long-term efforts and investments needed to create neighborhood of opportunity for everybody.

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Lauren Wechsler is a senior program analyst at CSSP.

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