Voices supports the proposed improvements to child care payment rates and the parent copayment requirements. These proposed changes will greatly impact the under resourced child care sector as well as help parents who are looking for care, so that they can continue to work. While it has been long recognized that child care programs need more resources to provide quality care, educators need higher wages and parents need lower costs to afford the care. Solutions have often been piecemeal and insignificant with regards to impact in all three areas of need. This proposal has the potential to transform how staff are paid, how parents choose quality, affordable care, and how quality improvement resources are provided.
Virginia is ranked 10th highest in the nation for child care costs. The average annual rate for an infant is $14,063 and $10,867 for a preschooler.
In 2021, Voices supported Senator Jennifer McClellan’s proposal to improve child care by funding the true cost of quality care (SB1316 Bill Explainer). The adoption of this legislation prompted the Virginia Department of Education (VDOE) to examine its payment practices and to seek approval from the federal government to use an alternative payment methodology to set rates based on program inputs. During the pandemic, VDOE has had the ability to waive parent co-payments which has provided relief when many families experienced economic hardship. New copayment rates will help to reduce the burden on parents participating in the subsidy program. Recent policy changes have also improved the ability for parents to participate by raising maximum income requirements, removing child support requirements, and ending a lifetime limit of 72 months for receiving assistance.
Impact of Proposed Changes on Program Funding
The new payment rates have been set to reflect the costs of program inputs by including wages, program standards, curriculum, and quality improvement activities. Payment rates have been posted online and can be compared to previous rates. Under the previous reimbursement rate process, the market, or what parents could pay in a specific community, drove the costs. The new model considers rates at a regional level and takes into account different types of licensures. In doing this, it recognizes the educators in the classroom as the critical inputs, not the physical location.
As payment rates are currently set by the age of the child, type of setting, and locality, the impact of the new payment rates in comparison to the old rates varies significantly across these three areas. Voices took a look at the new rates across jurisdictions to better understand impact. While there are a few localities who will not see rates increase for the preschool or school-aged age groups, every locality will see rate increases for providers. Each locality is now grouped into a region where the regional rate is equal across jurisdictions (unless the original market was higher).
Some providers and jurisdictions will see minimal increases of $5 per day, or slightly less. However, a $5/day increase for child served for 260 days throughout the year would equal a $1,300 increase for the program. Some localities and providers will see much larger increases in the magnitude of $20-35 per day. A $20/day increase (for example, in a center serving infants in James City County) would equal $5,200 additional resources per year and a $35/day increase (for example, in a center serving infants in Wythe County) would equal $9,100 per year.
As with any cost calculation, there will be some “winners” and “losers”. Providers in Northern Virginia will not see the same scale of increase as providers in more rural areas of the state. However, families looking for infant and toddler care will see significant rate increases as will home care providers serving school-age children. As we look to additional changes for payment practices and participation in the coming years, the state should consider the localities that do not receive significant increases in this proposal as a priority population. In particular, providers in Northern Virginia are not provided significant rate increases despite recent policy changes for Washington DC that increased rates and educator compensation. Failing to compete at the regional level could incentivize Virginia-based early educators to transition to nearby jurisdictions paying more.
The proposed changes will roll out in three phases:
Phase I: Regional payment rates determined by cost to be implemented Oct 1, 2022.
Phase II: Create a voluntary wage scale to encourage programs to increase wages over time.
Phase III: Provide additional supports forcontinuous quality improvement based on VQB5 assessments.
Impact on Early Educator Wages
While the rate increases could impact programs to a varying degree depending on subsidy enrollment, ages of children, and jurisdiction, those who are receiving the increase will be asked to participate in a voluntary wage scale allowing VDOE to collect information on the current wages and to offer a benchmark to ensure educators are paid higher wages as a result of the rate increase. This wage scale is a very exciting component to help increase the compensation for early childhood professionals and family home care providers. Compensation was modeled to factor in the wages that teachers in public preschool programs were paid to put their private counterparts on equal footing. The voluntary scale will allow Virginia an opportunity to measure progress towards increasing compensation, particularly when other neighboring localities to Virginia have made this a focus.
Impact on Parent Copayments
The child care subsidy program can be an extremely valuable benefit to working families, but only if it provides the continuous affordable coverage they need to work. Proposals to reduce the parent co-pays and collapse income levels will help reduce benefit cliffs where families receive diminishing returns for higher wages by reducing their access to public benefits. The impact of the proposed changes would save some families $600 per year while others could save thousands of dollars. Families earning less than the poverty level (who currently make up 43% of children enrolled) would pay no copays under the proposed changes. These families would go from paying about $50 per month to no monthly contribution. Families just over poverty (100-200% FPL) would pay $60 per month in comparison to $135-185/month under the current structure, and parents above that rate would pay $120-180/month. Providers are allowed to charge parents for any difference between tuition rates and what is covered by subsidy reimbursement and parent co-pays.
Public Comment Opportunity
The reimbursement rate changes are program manual changes that do not require legislative approval, but will go through the public comment process and will be presented to the Board of Education.
Public comments on the proposed changes can be emailed to firstname.lastname@example.org by July 25, 2022. The current timeline has reimbursement rates taking effect October 2022 and copayment changes would take effect January 1, 2023.
Virginia reached an important policy milestone this year — the General Assembly approved a state refund for a portion of the Earned Income Tax Credit (EITC) available to low-income working families. For the 2023 tax filings, families who qualify for the EITC will receive the refund on their federal taxes. At the state level, Virginia will give an additional refund equal to 15% of the federal refund.
Tax refunds help families experiencing material hardship or poverty meet many of their basic needs and can be used as needed to pay off debts, pay rent or put food on the table. These refunds are especially impactful during times of inflation and when COVID response policies are starting to come to an end.
Later this summer or early this fall families will also receive a one-time tax relief payment due to larger than expected revenue surpluses in the state budget. People with taxable income will receive a refund, but those who earn too little to owe taxes will not. And unlike the EITC, family size will not be factored into the payment—only marital status. These one-time refund plans fail to consider the additional expenses of feeding a larger family or child care needs for families with young children.
What Could Be Next for Families?
While this year marks an important step to provide more families with tax relief, it is helpful to take a step back and see where other states have built policies to support families. As most other states have wrapped up their legislative activity for the year, we can share how other states have designed tax refund policies that specifically support children and families.
Recently ten states* have introduced legislation to create state-level child tax credits. Vermont is the most recent state to approve a child tax credit for families with children under five earning less than $125,000 per year. Vermont now joins the nine other states who have a child tax credit already in place for families (California, Colorado, Idaho, Maine, Maryland, Massachusetts, New Mexico, New York and Oklahoma).
These states have provided a model that Virginia should consider. These are states who are governed by both Republicans and Democrats, but they have united behind state refunds to support families. Targeting refunds, in conjunction with the refundable EITC, impacts families’ economic security and lowers their level of hardship. Economic hardship is a main reason that children and parents experience trauma, depression, emotional distress. These negative outcomes mean economic hardship also puts children at risk of entering foster care. Additional state refunds can reduce these negative outcomes. Research on the federal child tax credit found that families used the additional funds to meet basic needs for food, utilities and clothing.
By targeting tax credits to low-income families, these refunds can also reduce inequity. Black and Brown families make up the lowest income families in Virginia and experience disproportionate economic hardship. Choices to expand the EITC and to target Child Tax Credit can provide more financial resources to the families who have often been left behind.
In the coming months, we anticipate waves of financial uncertainty for families dealing with higher gas prices, increasing rents, and universal free school meals coming to an end. If lawmakers provide additional savings and stability to communities facing uncertainty, our families would feel better about providing for their families and their children would feel more secure.
We all want Virginia to be the best place to raise children and provide opportunities for them to grow up, but our tax policy is not in line with that belief. It’s time to join the other states in prioritizing children and families and offer targeted tax relief to families.
*Connecticut, Hawaii, Illinois, Iowa, Kansas, Michigan, Missouri, Oregon, Vermont and West Virginia
The momentum was in place for children’s mental health in Virginia. The US Surgeon General and key advocates declared a national emergency to confront a decade-long decline in children’s mental health. Despite widespread concern, Governor Northam’s original budget proposal did not fund new programs in schools for children’s mental health. To meet the moment, a bipartisan group of legislators and advocates from various communities lobbied for investments in psychological services and counseling. Additional resources of $1.4 million per year will expand the Virginia Mental Health Access Program to integrate services in health care settings. Noted below are other new investments integrating mental health in school settings, increasing reimbursement rates, and supporting the workforce.
A First Step for School-Based Mental Health Integration
Over the last three years, the General Assembly has focused on improving school-based mental health by funding specialized student support positions—counselors, social workers, and psychologists. While students have benefited from better relationships with faculty, COVID presented unanticipated disruptions, rapidly increasing needs, and barriers to vital care. School divisions have responded by allocating federal recovery funds into training, coaching, and even bringing community-based mental health professionals into schools.
However, federal support during this emergency is impermanent and mental health threats are ongoing. School divisions need resources to continue to support these efforts. Voices led advocacy for additional state general fund resources supporting school-based mental health in flexible ways to assist school divisions in identifying key partnerships and resources. The General Assembly allocated $2.5 million in FY23 to begin supporting school-based mental health services and included language asking the newly established Behavioral Health Commission to study how schools can better integrate mental health services with sustainable funding streams such as Medicaid.
The General Assembly also approved funding to establish a regional Recovery High School based in Chesterfield where substance abuse recovery is incorporated into the school day. The proposal by Delegate Carrie Coyner was finally approved after the 2020 COVID response cut funding. Other high schools will be able to look toward this model to support health needs in the classroom.
The lynchpin to support the social and emotional well-being of students is having an appropriate workforce. We are excited about two changes that will help address pressing workforce challenges.
The House and Senate approved HB829, proposed by Del. Tony Wilt, that will provide flexibility on a provisional basis for licensed mental health professionals without certification to work in school-settings. This flexibility will ensure that school divisions can hire more mental health staff.
The budget adopted by the General Assembly includes funding for a new initiative to help mental health professionals seeking licensure when they must pay for their supervision time out-of-pocket. The new initiative, Boost200, will provide resources to cover out-of-pocket expenses for licensure and match them with approved supervisors. This initiative is poised to make a significant impact on removing barriers towards licensure and diversifying the mental health field. Learn more about participating to address licensure costs or to work as a supervisor.
Improving Medicaid Reimbursement Rates
The third area that the legislature improved on mental health services was improving Medicaid reimbursement rates for several mental health services. Federal funds from the current “public health emergency” have increased payment rates for community-based services by 12.5%. The General Assembly approved resources to continue financing those services. The General Assembly also improved rates for psychiatric residential treatment facilities. Many facilities served children from other states and lacked placements for children in Virginia, leading to greater instability for the hardest to place children, who are the focus of the Safe and Sound Task Force. The increased rates should help caregivers meet immediate needs, but challenges remain to ensure that children are not placed in inappropriate and lengthy stays in congregate settings. While increasing Medicaid rates is a positive step, adequate reimbursement is essential to looking after the mental health of economically disadvantaged children and vulnerable children in the foster care system.
Virginia lawmakers continued to create a path for growth and expansion in early education with the outcomes of the budget negotiations in the 2022 General Assembly Session. Building off years of historic state and national investments, the legislature approved significant resources for early childhood for FY23-24. The legislature approved several new initiatives and the bulk of the early childhood expansion proposals in Governor Northam’s outgoing budget.
After years of significant strain on the child care industry and after a House of Delegates proposed budget made significant cuts to Northam’s proposals, early childhood advocates have something positive to celebrate in this state budget. The final compromise left most of his proposal in place. In recent comments, Governor Youngkin recognized a significant bi-partisan shift to support early education that he hoped the legislature would restore funding to early education.
Below are the initiatives that will strengthen early education and the child care sector in the budget. In total, the budget includes an additional $76 million in state funds and an additional $7.5 million in ARPA funding for early education and child care.
Six bipartisan legislators received Child Care Champions Awards from the Virginia Promise Partnership at an awards reception on June 1, 2022.
Creating a Stronger, More Equitably Resourced Early Education System
A combination of policy changes in legislation and language in the budget will strengthen the alignment and oversight of early education programs.
The Regional Early Education System and Overpayment Fund HB 389, sponsored by Del. Bulova, was signed into law to create the structure for Ready Regions throughout Virginia and capture any overpayment to localities of subsidy funds so it does not revert to other areas.
Increasing the VPI per-pupil allocation to $8,359 will reflect the true cost of quality early education programs. In addition, language asks the Department of Education to conduct an annual benchmarking of VPI funding, as is done with other K-12 funding streams.
Language for more flexibility in the use of VPI funds will allow school divisions to serve more students with disabilities and expand to serve 3-year-olds in VPI funded programs.
An additional $6.7 million will expand public/private options for state-aligned preschools through the VECF mixed-delivery program. These funds will support the early childhood education of an estimated additional 500-600 students, including 200 infants and toddlers.
The legislature has directed $3.5 million in ARPA funds to the United Way of Southwest Virginia for a new initiative expanding child care capacity, “Ready Southwest”.
Compensation and Retention for Early Childhood Educators
The approved budget will expand the early educator incentive grant program by an additional $5 million per year to recruit and retain early childhood professionals.
While reforms to the hiring process and background checks for provisional employment did not move forward, the Commissioner of Social Services has begun a process review and promise to address the timeliness of background checks.
Accessibility and Affordable Care for All Children
Building off the legislation that passed last year, the new budget continues to expand child care assistance eligibility and reduces parent co-pays. Families with children under five, up to 85% of the state median income, and families looking for a job are eligible now for this assistance. The budget also eliminates the 72 month time limit to receive assistance, removing an arbitrary time limit for families who may have multiple children who could otherwise qualify for assistance.
The legislature also provided $4 million in ARPA federal funds to support 21st Century Community Learning Centers. These federal funds will strengthen school-based, out of school-time, programs that are affordable.
Governor Youngkin signed SB69 sponsored by Sen. Favola allowing home-based child care programs to be approved on the site of rental properties.
The legislature provided a $2.9 million increase each year to the base allocation for Part C Services early intervention services funded through DBHDS. This will contribute to services for infants and toddlers with developmental disabilities and delays.
Pictured above: Chief Policy Officer Emily Griffey with her child, Andy
I’ve been a working mom for most of my career at Voices. Balancing motherhood and work has allowed me to experience firsthand the ups and downs of the early education system. Paying more than a mortgage for child care, searching for care when the pandemic closed our preschool, as well as getting to know and personally support the educators in the field have all strengthened my advocacy for early education.
I also feel compelled to highlight a nuance of Women’s History Month—that while women are at a disadvantage in the workforce, mothers are at an even greater disadvantage. The fact that the gender pay gap becomes even greater for mothers in the workforce is called the “motherhood penalty” and has been cemented in sociology as a worldwide phenomenon. One analysis by The Century Foundation of mothers with children under five found that White mothers earned 10% less than childless counterparts, while Black mothers earned 20% less and Latina mothers earned 18% less.
Being a mother is a hard job. Working to earn less money than your counterparts is even more difficult to stomach when your costs are even higher to care for your family.
The pandemic has added additional complexity for working mothers. During the pandemic, working mothers were more likely to consider leaving the workforce than working fathers. Economists have also reported more than 1 million fewer women with school-age children in the workforce than prior to the pandemic. Opting out of the workforce has individual spillover effects: the time not spent participating in the workforce may reduce pay based on experience for mothers and can contribute to workforce shortages. Recently, I participated in an RVA Engage panel with Kartik Athreya from the Richmond Federal Reserve. He shared some interesting thoughts on women’s labor market participation, the economic forces at play, and the role that policy choices can play in helping mothers decide when there are economic trade-offs. Review a recording of the full panel and his resources here.
To fully appreciate the role of women and mothers as leaders in our communities, we need policy changes that are family friendly and directed to mothers.
State budget negotiators can take a step to address the motherhood penalty with the tax policy choices they make for the upcoming fiscal year.
Supporting the refundable Earned Income Tax Credit (EITC) would target low-income taxpayers, who are more likely to be single-headed households. 72% of the filers who receive the EITC have children in their household.
Adjusting the one-time tax relief payment to include children, “the parent payment”, would cover the additional costs of raising children as data show mothers experience a wage penalty.
Make sure working families can access and afford child care by keeping higher income limits for eligibility for financial assistance and allowing mothers to receive assistance while looking for work.
Expanding paid family leave allows mothers to care for their new babies and sick children in the face of childcare disruptions without having to sacrifice their income and health insurance. Federal and state lawmakers have delayed policy changes to support paid leave which continues to stall mothers from returning to the workforce.
I’m proud to be a working mother, but it doesn’t come without sacrifice. For the other working mothers who are serving their communities, leading businesses and caring for others, your contributions are invaluable. It’s past time for lawmakers to recognize and reward these contributions.
Parents have faced numerous challenges due to the COVID-19 pandemic. Child care closures made it more difficult to work. Employment uncertainty and illness made it more difficult to plan ahead. And inflation has impacted day-to-day expenses, where lower income families feel an even greater impact. These material hardships also put an emotional toll on families. Parents have repeatedly reported higher than typical levels of stress and anxiety during the pandemic. Being a parent on a normal day is not an easy job, let alone living through two years of the pandemic.
In this time of unprecedented tax revenue surplus in Virginia, more than $13 billion over three years, it is time to deliver relief and put money back in the pockets of parents. With multiple tax credit and tax deduction options under consideration, state lawmakers should prioritize ones that benefit low-income families.
On February 24, 2022, Voices held a press conference, along with Families Forward Virginia and The Commonwealth Institute, to demonstrate how parents could benefit from these tax policy choices and why they need relief. Crystal, a mom living in Franklin, VA asked legislators to act on these tax choices, “I’ve climbed out of the depths of hell to get where I am today…families like mine who are having to decide whether to pay bills or put food on the table.”
Current Tax Policy Options Considered by the Virginia General Assembly
Partially Refundable EITC
The partially refundable Earned Income Tax Credit (EITC) would benefit approximately 600,000 tax filers in Virginia. This credit is targeted to the lowest income tax filers, most with incomes below $75,000 a year, and the majority are working families with children.
This option would send a refund check to families in 2023 for the portion of their tax refund that is less than what they owe in state taxes. Currently, tax filers only receive a refund for the federal portion of their taxes. Families could receive an additional $500 refund in the future depending on their income and family size. Learn if your family might be eligible using this EITC calculator from The Commonwealth Institute.
This option would cost approximately $200 million per year to provide annual tax refunds to lower income working families. The Senate has accepted this proposal, but the House budget includes a different proposal that doubles the standard deduction and reduces available revenues by approximately $600 million per year.
One Time Taxpayer Relief Payment -> “Parent Tax Relief”
Another option would come from the one-time surplus of revenue in Virginia—a taxpayer relief payment to all tax filers that would arrive sometime between July and November 2021. The General Assembly has created one-time relief payments with one-time surpluses in the past, most recently in 2019. This proposal was included in Governor Northam’s outgoing budget as a relief payment of $250 for single filers and $500 for joint filers. With higher projected tax revenues, Governor Youngkin has proposed increasing the payments to $300/$600. Both the House and the Senate are planning to provide the one-time relief payments, but the Senate budget does not include a specific dollar amount or plan at this time.
We think it’s time to revisit this proposal to provide more tax relief to families. The current proposal treats tax filers of all income levels the same and does not assume that families with children have higher expenses. Lawmakers have noted that higher income taxpayers do not need the tax relief as much as lower income families, but have not revamped with proposal. With a total estimated cost of $1.2 billion in one-time revenues, we think there is room to make adjustments in this proposal by including an income cap and adjusting payments based on the number of dependents on a family’s state tax return.
Adjustments to the one-time relief payment could provide a family $1,200 in relief funding compared to $600 as a married filer or $300 as a single filer. One in four taxpayers in Virginia has children in their household. Adjustments to incorporate family size could cost approximately $600 million out of the $1.2 billion. Including an income cap could ensure that taxpayers without children also receive the one-time payment.
Including children in this calculation recognizes that families have higher costs to put food on the table and cover housing. It also recognizes that economic stability has a positive effect on children, including the very youngest children, especially on their healthy growth and development. Lawmakers should factor in families when considering the one-time relief options.
The Commonwealth Institute for Fiscal Analysis joins Voices for Virginia’s Children as a guest-contributor for this analysis of Virginia’s tax policy; edited for the Voices’ blog.
While most parents dread filing taxes each year this chore can connect working families to federal relief in the form of a tax refund or rebate. That refund check often brings smiles and financial relief to homes. When sifting through tax-filing sites or accounting services, working families may notice they qualify for a tax credit for disclosing expenses for child care, health care, or education. In many cases, the credit reduces the overall tax burden and can be returned as a refundable credit or rebate: a check from the US Treasury or State Treasury or a direct deposit to your account.
The Virginia and federal tax systems have different rules about qualifying credits and deductions. This year, the federal tax program for families will include the second half (six months’ worth) of the Child Tax Credit payments. You may have received a letter stating what benefits you already received and will be eligible to receive when filing your taxes for 2021. While prolonged debate on the Build Back Better Act has halted the flow of monthly payments, families will receive the remainder of the Child Tax Credit payments when they file taxes this spring.
But for now, the monthly, expanded child tax credit payments have ended. We hope Congress will unite to revive Child Tax Credit payments in the coming months.
In the meantime, there are two issues the Virginia legislature is considering:
Conformity to Federal Tax Laws for 2021 Would Benefit Young Adults
In Virginia, emergency legislation from Senator Janet Howell (SB94) and Delegate Kathy Byron (HB1003) would align the state’s rules to federal rules. Adopting the new federal rules for the Earned Income Tax Credit (EITC), among other improvements, would entitle Virginia families and young adults with up to 20% of the federal credit.
For young adults without children, the Federal maximum benefit for “childless tax filers” has increased to $1502. At a state level, young adults would be entitled to up to $300 credit on their state income tax. However, for 2021, the state credit is not refundable, so conforming to the federal EITC would reduce state tax burdens but would not provide a state rebate. Meaning, that young adults and former foster youth could owe fewer taxes this year.
Adopting the Earned Income Tax Credit would offer state tax credits to the following young adults:
19 and older: if working enough to earn taxable income;
24 and older: if pursuing education for at least five months of the year;
18 and older: if they were in foster care any time after they turned 14 or were homeless in any taxable year
A partially refundable credit would better center the needs of low-income families and families of color in our state budget. And if Congress makes any federal changes and advances the Build Back Better Act, young adults could look forward to refundable credits among other support.
As Congress is poised to act on the social infrastructure agenda known as Build Back Better, we wanted to give a better sense of the transformational impact this legislation will have on kids and families. The goal of Build Back Better is to address the inequities that existed before the pandemic and have been exacerbated by the pandemic. The policies are intentionally designed to target economically disadvantaged children, children of color, and women to provide the resources that have previously been unavailable or unaffordable. These policies will also deliver immediate relief to families by continuing the monthly Child Tax Credit payment for the lowest income families and improves conditions in the long-term by providing more equitable access to child care and prenatal care.
UPDATE 11.5.21- House of Representatives Vote
Today the House of Representatives will vote on the Bipartisan Infrastructure package and the Build Back Better Act. The Senate has already approved the Infrastructure bill so it will head to the President. The Senate has been given a deadline to approve Build Back Better before Thanksgiving and the contents could change to reach an agreement between the House and Senate. Particularly at risk in the Senate are the paid family leave provisions.
Our hope for Build Back Better was that it would provide the three things we heard from families throughout the pandemic that they needed most—child care assistance, flexible cash assistance through the Child Tax Credit, and paid family medical leave. House negotiations and incredible advocates have made it possible to put four weeks of paid family leave back into the bill. It will be critical to continue to speak up to ensure it stays in the Senate version.
There are many provisions of the Build Back Better plan. Here are some key highlights for children and families:
Extension of the enhanced Child Tax Credit for one year:
The new framework keeps the higher payment amounts and fully refundable payments in place for another year. This will allow for the families who previously earned too little to qualify for the benefit to receive assistance and for “little DREAMers” to qualify. This expansion will impact Black and Latinx children significantly as more than half of the children who were previously excluded for earning too little were children of color. The flexible cash assistance provided through the Child Tax Credit will continue to help families cover basic necessities like food and child care.
Transformational investments to make child care and preschool more affordable and accessible:
Congress’s $400 billion investment in child care and preschool will dramatically impact a system that is struggling to recover from the impact of the pandemic and help get mothers back into the workforce. The comprehensive proposal addresses the child care supply and affordability angle from all sides—it reduces parent costs to no more than 7% of income, provides resources to increase early educators compensation, and builds on a mixed-delivery system of public, private, and Head Start programs. With funding specifically for 3’s & 4’s in preschool, this significant investment provides an opportunity to improve the child care assistance policies around the needs of infants and toddlers.
Child and maternal health improvements to address racial disparities:
While Virginia lawmakers have already approved the extension of Medicaid eligibility for 12 months postpartum, Build Back Better makes this extension a requirement for states. It also includes all of the provision of the Black Maternal Health Momnibus package, which would support training and diversification of the perinatal workforce, maternal health quality improvements, better data systems to track and identify causes of maternal mortality, investments in historically Black colleges and universities to conduct research into maternal health disparities, and grants to support implicit bias training for frontline health care professionals.
For children, the legislation would require Virginia to provide 12 months of continuous eligibility for Medicaid and FAMIS. Currently about 5% of children enrolled in Medicaid/FAMIS lose their coverage during the year. It also makes the federal funding for the Children’s Health Insurance Program (known as FAMIS in VA) permanent.
Improvements to nutrition access will keep children from going hungry:
Build Back better would provide better nutrition access to students by expanding the Summer EBT program allowing eligible families to receive additional assistance to purchase meals during the summer months or while schools are closed. The proposal also strengthens the Community Eligibility Provision that allows schools to opt in to provide free meals to the entire school enrollment.
House version provides four weeks of paid family medical leave:
Parents need paid family medical leave after the birth of their children, when kids are sick, to care for other families and to provide for their own health. The U.S. is alone among wealthy nations for not providing a paid family leave program. The House proposal would create a program to offer every worker access to a national paid family medical leave program. Creating a universal program will impact more parents of color working in jobs who currently do not offer paid leave. And importantly, it will give more new parents time off to care for their newborns and for mothers to recover from giving birth.
More to come…
While more details are forthcoming, the bill also includes investments in trauma-informed care peer support specialists. here are also provisions on immigration reform and affordable higher education that we are monitoring. It’s now up to Congress to act on or improve on this bill. Watch this space for more detailed information on the proposals. Stay tuned on our blog and sign up for emails to get the latest updates.
Advocates, school personnel, mental health clinicians, and families have been saying for years – even before the pandemic – that children’s mental health access is in a state of emergency. Over the summer, we heard from outpatient treatment clinicians who had months-long waiting lists and emergency departments that were filling up with children in mental health crisis without other options. As school returned, more reports of mental health and behavioral disruptions resonated across the Commonwealth. Now, the American Academy of Pediatrics, American Academy of Child and Adolescent Psychiatry and Children’s Hospital Association are declaring a “National Emergency” in children’s mental health.
Virginia lawmakers are paying attention too. During a discussion about education funding in a Senate Finance Committee meeting, Senator Jennifer McClellan stated, “the kids are not okay.” The compounded effect of the pandemic, racial trauma, and individual traumatic experiences are causing anxiety, depression, and more severe mental health issues in students. It was evident to Senator McClellan as a parent that mental health is causing major distress and barriers to learning.
Young people are ready for policymakers and leaders to address this emergency.
Justice, a young adult in Richmond told us this week, “I believe that if we can put more free mental health services out there for young people to turn to if they don’t have somebody to talk to they won’t just keep things in and one day just explode… It’s okay to not be okay.”
Children’s Mental Health Discussion Paper: October 2021
Children’s mental health needs touch all systems and all aspects of life. To fully address children’s mental health issues, we need an “all-hands-on-deck” approach. There are no easy solutions to address a “state of emergency” but there are many points to begin trying.
Voices has released a discussion paper for lawmakers to tackle children’s mental health issues from the perspective of the child-student and outside any one silo. This paper is relevant for lawmakers serving on the education funding committee, health and human resources funding committees, and the newly formed Behavioral Health Commission. It also creates a framework for the incoming governor to tackle a pressing issue and create some opportunities to continue collaborative efforts such as the Children’s Cabinet.
The most important steps lawmakers must take to address the current emergency include:
Addressing workforce shortages. Children’s clinical workforce shortages existed even before the pandemic, but overall workforce shortages are contributing to even longer waits for care. We need to retain the current workforce, attract a future workforce, and align the current workforce to opportunities for licensure and appropriate reimbursement. We support a proposal in front of the Behavioral Health Committee and consideration for the governor’s budget to assist clinicians in paying for supervision towards licensure to help meet immediate needs. Additionally, retention bonuses proposed for providers in the public mental health system and loan repayment programs are critical. In the longer term, stakeholders and leaders should spend time defining the best fit for certain roles, particularly the roles that can be filled by Qualified Mental Health Professionals (QMHPs) in schools and community settings.
Building out the capacity of health providers to address mental health issues. Continuing efforts to expand the Virginia Mental Health Access Program to reach more health providers, such as emergency department staff, and enhancing awareness of early childhood mental health issues are necessary. Additional recruitment and professional development for the health care workforce to identify and address mental health needs can help children who might not have robust school-based services.
Facilitating connections between schools and community providers. School have gotten very creative at finding ways to meet mental health needs during the pandemic. And thanks to investments from state lawmakers, many have been able to add additional school counselors and specialized support staff. For these new initiatives to meet increased demand and increased severity of need, the schools will need support to implement trauma-informed and multi-tier support from the state Department of Education and from their school divisions.
Additional federal resources and Medicaid reimbursement will be critical to supporting school-initiated services in the long-term. There are several opportunities to create strong support systems for student mental health with American Recovery Act funds, the recalibration of Medicaid-funded mental health services through Project BRAVO and the ability for schools to bill for health and mental health needs outside a students’ IEP through the “free care” rule. Stakeholders, students, providers and schools should come together on some ideal plans and programs to implement at the school and child care level to meet student needs.
Frequently, our job as advocates does not end when a policy passes the General Assembly. We need to know more detail about how the policy is reaching its intended goals and how we can improve the policy. Two recent examples from policies implemented during the summer months of 2021 point to two different stories and raise questions about how our state agencies, policymakers and stakeholders can help support targeted outreach to specific families.
Story #1: FAMIS Prenatal Coverage Changes Prompt Immediate Enrollment Successes
DMAS rolled out FAMIS Prenatal coverage for pregnant undocumented women on July 1, 2021 and has reported at a recent meeting of Medicaid stakeholders that more the 1,400 pregnant women enrolled in health insurance by the end of August. The income-eligible undocumented women will receive comprehensive health benefits through 60 days postpartum. Prior to the launch of FAMIS Prenatal, DMAS had enrolled slightly less than 400 pregnant women per month. During the first full month of FAMIS Prenatal enrollment more than 1,000 pregnant women enrolled. While data is not yet available with the new “FAMIS Prenatal” category, DMAS reports monthly enrollment figures for pregnant women, children and adults that can be tracked here.
While outreach for benefits in multiple languages is often difficult, DMAS and partners at Cover VA (Cubre VA) and Enroll VA are working to ensure that information is available in English and Spanish. These initiatives allow staff to offer individual support, navigate the enrollment process, and ensure applications are completed or help problem solve. These dedicated navigators can help build trust in the enrollment processes and ensure successful completion of enrollment.
The strong participation in FAMIS Prenatal shows that a policy change to cover undocumented women was needed and we hope that it will result in healthy births and healthy moms. It also shows the potential of engaging groups that have been previously excluded from eligibility when we expand the reach of coverage.
Story #2: Child Tax Credit Monthly Allowance Participation Raises Concerns About Outreach & Engagement
July 2021 also was the first month for monthly child tax credit payments to get direct deposited into accounts or mailed to recipients. Most families with children who filed taxes in 2019 or 2020 received direct deposits to bank accounts on file with the IRS or checks mailed home. These direct deposits came to bank accounts as “IRS TREAS 310 CHILD CTC”. If you did not receive a payment, visit the Child Tax Credit update portal.
While the first month of checks were excitedly received by many families to cover summer child care, meals and back-to-school expenses, families who previously earned too little to file taxes did not receive an automatic payment and were asked to produce information in a “non-filer portal”. These IRS portals allow easy initial access for individuals with smart phones and internet access, but they are not always easy to navigate and some specific identify verification steps were available in English only.
A research institute at Washington University in St. Louis produced a report for the Annie E. Casey Foundation on the initial participation in the Child Tax Credit during the month of July and found that families who identified as Hispanic in Virginia were significantly less likely to receive the tax credit than Black families or white families. Less than half of low-income Hispanic families received the credit in July compared to more than 70% of low-income Black and white families. Read Virginia’s fact sheet. This finding raises as alarm that the credit is not reaching all families equally and some intentional outreach should be provided to Hispanic and non-English speaking families.
For stakeholders who want to help Spanish-speaking families receive the credit, getctc.org/es is available to help navigate website and materials.
Steps to Improve Outreach
To improve outreach to Latino families, Virginia should always include resources to help translate materials and to train and educate stakeholders on initiatives in languages other than English.
It’s not too late to help Latino families receive the Child Tax Credit. Strategies that worked for health insurance enrollment and additional partnerships can be put in place now. State leaders should look to current year surplus funds to make sure resources are available during the 2021 tax filing season.
Provide support to file taxes in 2022: If families earn too little to qualify and have been unfamiliar with IRS processes or hesitant to file taxes, they can still be encouraged to use the non-filer portal before the end of the year, or to file their taxes in 2022 to claim the full amount for 2021. Additional resources should be provided for free tax filing and troubleshooting.
Partner with trusted community organizations: Community-based networks, United Ways and local philanthropy should help build bridges between trusted community organizations and tax preparation services to link families to help. Free resources like this CTC navigator training from Code for America are available to help community organizations better understand the process.
Provide one–on-one navigator support for other financial benefits: The successes of health care enrollment can be replicated by providing support to families to help them navigate other financial benefits such as tax credits, nutrition assistance, child care assistance and more. The state should provide training and resources to navigators in trusted community organizations and additional expertise to help more complicated situations that require problem-solving. Additional training and a statewide “support line” provided in English and Spanish could help families unlock resources to achieve stability.
Child Tax Credit Resources
GetCTC.org: information about CTC, and the GetCTC simplified return tool, in English and Spanish.
GetYourRefund.org: free tax prep services and FAQs for clients who want to file a full return in English and Spanish.
IRS CTC Update Portal: the IRS tool to check CTC eligibility status, opt-out of advance CTC payments and provide updated bank account and mailing address information for those who have already filed a 2019 or 2020 tax return.
IRS CTC Helpline: (800) 908-4184. The helpline connects clients to IRS representatives who can answer basic CTC questions. Assistance is available in English and Spanish. If a caller does not have access to the internet and does not have a friend or family who can help them do so, phone operators can also help callers opt-out of advance CTC payments. The caller will need to tell the operator that they can’t access the internet, and can’t get assistance to do so.
Alcance dirigido a las familias latinas: ¿Qué más debe hacer Virginia?
A menudo, nuestro trabajo como defensores no termina cuando una política es aprobada por la Asamblea General. Necesitamos aprender más detalles sobre cómo la política está alcanzando sus objetivos previstos y cómo podemos mejorarla. Dos ejemplos recientes de políticas implementadas durante los meses de verano de 2021 apuntan a dos historias diferentes y plantean preguntas sobre cómo nuestras agencias estatales, los responsables de las políticas y las partes interesadas pueden ayudar a apoyar el alcance dirigido a familias específicas.
Historia 1: Los cambios en la cobertura prenatal de FAMIS provocan un éxito inmediato en la inscripción
El DMAS puso en marcha la cobertura prenatal de FAMIS para las mujeres indocumentadas embarazadas el 1 de julio de 2021 y ha informado en una reciente reunión de las partes interesadas de Medicaid que más de 1.400 mujeres embarazadas se inscribieron en el seguro de salud a finales de agosto. Las mujeres indocumentadas que reúnan los requisitos de ingresos recibirán prestaciones médicas completas hasta 60 días después del parto. Antes del lanzamiento de FAMIS Prenatal, el DMAS había inscrito a algo menos de 400 mujeres embarazadas al mes. Durante el primer mes completo de inscripción de FAMIS Prenatal se inscribieron más de 1.000 mujeres embarazadas. Aunque aún no se dispone de datos con la nueva categoría “FAMIS Prenatal”, el DMAS informa de las cifras mensuales de inscripción de las mujeres embarazadas, los niños, y los adultos que se pueden seguir aquí.
Aunque la difusión de los beneficios en varios idiomas suele ser difícil, el DMAS y sus socios de Cubre VA y Enroll VA están trabajando para garantizar que la información esté disponible en inglés y español. Estas iniciativas permiten que el personal ofrezca apoyo individual, navegue por el proceso de inscripción, y se asegure de que las solicitudes se completen o ayude a resolver problemas. Estos navegadores dedicados pueden ayudar a crear confianza en los procesos de inscripción y asegurar la finalización exitosa de la inscripción.
La fuerte participación en FAMIS Prenatal demuestra que era necesario un cambio de política para cubrir a las mujeres indocumentadas y esperamos que se traduzca en partos y mamás saludables. También muestra el potencial de involucrar a grupos que han sido previamente excluidos de la elegibilidad cuando ampliamos el alcance de la cobertura.
Historia 2: La participación en la asignación mensual del crédito fiscal por hijos suscita inquietudes sobre el alcance y la participación
Julio de 2021 también fue el primer mes en que los pagos mensuales del crédito fiscal por hijos se depositaron directamente en las cuentas o se enviaron por correo a los beneficiarios. La mayoría de las familias con hijos que declararon impuestos en 2019 o 2020 recibieron depósitos directos en cuentas bancarias archivadas en el IRS o cheques enviados por correo a casa. Estos depósitos directos llegaron a las cuentas bancarias como “IRS TREAS 310 CHILD CTC”. Si no recibió un pago, visite el portal de actualización de Child Tax Credit.
Mientras que el primer mes de cheques fue recibido con entusiasmo por muchas familias para cubrir el cuidado infantil de verano, las comidas y los gastos de vuelta a la escuela, las familias que anteriormente ganaban demasiado poco para declarar impuestos no recibieron un pago automático y se les pidió que presentaran información en un “portal de no declarantes”. Estos portales del IRS permiten un fácil acceso inicial para las personas con teléfonos inteligentes y acceso a Internet, pero no siempre son fáciles de navegar y algunos pasos específicos de verificación de identidad estaban disponibles sólo en inglés.
Un instituto de investigación de la Universidad de Washington en St. Louis elaboró un informe para la Fundación Annie E. Casey sobre la participación inicial en el Crédito Fiscal por Hijos durante el mes de julio y descubrió que las familias que se identificaban como hispanas en Virginia tenían muchas menos probabilidades de recibir el crédito fiscal que las familias negras o las blancas. Menos de la mitad de las familias hispanas de bajos ingresos recibieron el crédito en julio, en comparación con más del 70% de las familias blancas y negras de bajos ingresos. Lea la hoja informativa de Virginia. Esta conclusion hace saltar la alarma de que el crédito no está llegando a todas las familias por igual y que se debería realizar una labor de divulgación intencionada entre las familias hispanas y las que no hablan inglés.
Para las partes interesadas que quieran ayudar a las familias de habla hispana a recibir el crédito, getctc.org/es está disponible para ayudar a navegar por el sitio web y los materiales.
Pasos para mejorar el alcance
Para mejorar el alcance a las familias latinas, Virginia siempre debe incluir recursos para ayudar a traducir los materiales y para capacitar y educar a las partes interesadas en las iniciativas en idiomas distintos del inglés.
No es demasiado tarde para ayudar a las familias latinas a recibir el Crédito Fiscal por Hijo. Las estrategias que funcionaron para la inscripción en el seguro medico y las asociaciones adicionales pueden ponerse en práctica ahora. Los líderes estatales deben buscar los fondos excedentes del año actual para asegurarse de que los recursos estén disponibles durante la temporada de presentación de impuestos de 2021.
Proporcionar apoyo para presentar los impuestos en 2022: Si las familias ganan muy poco para calificar y no han estado familiarizadas con los procesos del IRS o han dudado en presentar los impuestos, aún pueden ser alentadas a usar el portal para no declarantes antes de fin de año, o a presentar sus impuestos en 2022 para reclamar la cantidad completa para 2021. Deben proporcionarse recursos adicionales para la presentación gratuita de impuestos y la resolución de problemas.
Asociarse con organizaciones comunitarias de confianza: Las redes comunitarias, United Ways y la filantropía local deben ayudar a construir puentes entre las organizaciones comunitarias de confianza y los servicios de preparación de impuestos para poner a las familias en contacto con la ayuda. Existen recursos gratuitos, como esta formación de navegador de CTC de Code for America, para ayudar a las organizaciones comunitarias a entender mejor el proceso.
Proporcionar apoyo individualizado para otras prestaciones económicas: El éxito de la inscripción en el sistema de salud puede repetirse proporcionando apoyo a las familias para ayudarles a navegar por otros beneficios financieros como los créditos fiscales, la asistencia nutricional, la asistencia para el cuidado de los niños y más. El estado debe proporcionar formación y recursos a los navegadores en organizaciones comunitarias de confianza y experiencia adicional para ayudar en situaciones más complicadas que requieran la resolución de problemas. La formación adicional y una “línea de apoyo” estatal proporcionada en inglés y español podrían ayudar a las familias a desbloquear los recursos para lograr la estabilidad.
Recursos del Crédito Fiscal por Hijos
GetCTC.org: información sobre el CTC, y la herramienta de declaración simplificada GetCTC, en inglés y español.
GetYourRefund.org: servicios gratuitos de preparación de impuestos y preguntas frecuentes para clientes que quieren presentar una declaración completa en inglés y español.
Portal de actualización de CTC del IRS: la herramienta del IRS para comprobar el estado de elegibilidad de CTC, optar por no recibir pagos anticipados de CTC y proporcionar información actualizada de la cuenta bancaria y la dirección postal para aquellos que ya han presentado una declaración de impuestos de 2019 o 2020.
Línea de ayuda de CTC del IRS: (800) 908-4184. La línea de ayuda conecta a los clientes con representantes del IRS que pueden responder a preguntas básicas sobre el CTC. La asistencia está disponible en inglés y español. Si la persona que llama no tiene acceso a Internet y no tiene un amigo o familiar que le pueda ayudar a hacerlo, los operadores telefónicos también pueden ayudar a las personas que llaman a renunciar a los pagos anticipados de CTC. La persona que llame tendrá que decir a la operadora que no puede acceder a Internet y que no puede recibir asistencia para hacerlo.