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Tag Archive: General Assembly

1. Prioritizing Youth Mental Health Requires Intention and Investment

   January 25, 2023 4:51 pm 2 Comments

   Whether you are a young person, a parent, a mental health professional, or an educator, you have likely heard about the youth mental health crisis in the United States—it is being discussed everywhere, from kitchen tables to news stations to the Governor’s office. And while there is finally urgency around addressing the mental health needs of Virginians, we continue to see a catch-all response for adult and children’s mental health needs in our current policies. It is undoubtedly easier to design mental and behavioral health systems and services for adults and retrofit young people into them, but this results in supports that inadequately meet the needs of children and youth. To truly invest in the mental health of young people, policymakers must do so with intention. It requires centering the needs and experiences of young people—especially those who are Black, Latino, and LGBTQ+—and developing mental health services that prioritize healing and well-being.

   The past few years have been particularly difficult for young people. The Joint Legislative Audit & Review Commission’s (JLARC) November 2022 report shared several alarming statistics that articulate the dire need to intervene and support young people right now: 

   • Self-harm-related emergency department visits among Virginia youth, ages 9 to 18, more than doubled from 2016 to 2021, with the largest increase in self-harm visits occurring in 2021, according to the Virginia Department of Health, and   
   • Youth deaths by suicide, ages 9 to 18, averaged 4.9 deaths per 100,000 youth from 2015–2019, and were 6.2 per 100,000 youth in 2020 and 5.6 per 100,000 in 2021.

   

   This constitutes a youth mental health crisis. In order to meet this moment for youth mental health, there must be major shifts in how children and youth are prioritized in our system. Historically, new initiatives and service expansions have delayed the implementation of child- and youth-focused plans until phase two—a step that often takes too long to achieve. Mental health resources that are not intentionally designed to reach children and youth will not reach them.

   Capacity to build up the infrastructure at local Community Services Boards, particularly for children and youth, is needed. The ideal system offers young people mental health support when and where they need it, but the reality is children and youth do not have access to a comprehensive array of crisis response services depending on where they live, who pays for their care, and who helps them identify resources.

   Currently, there are only three Residential Crisis Stabilization Units (RCSUs) specifically for young people across the Commonwealth. One goal of Governor Youngkin’s “Right Help. Right Now.” behavioral health transformation initiativeis to add more youth RCSUs and to develop 23-hour Crisis Receiving Centers (CRCs) to serve as a “behavioral health urgent care”, both of which are critical components of the crisis services continuum. However, if the locations and services are not developed with young people’s needs in mind, they will not be as effective of a resource. Having a cross-lifespan model for RCSUs and CRCs that only incorporate child-sized recliners does not make a space child- and youth-friendly. The design of RCSUs and CRCs must be fundamentally different from the design of a traditional hospital, which are often sterile and unwelcoming environments. Young people need culturally and developmentally appropriate resources in these locations, such as places for their family members to rest, blankets, sensory toys and comfort items, and a warm and inviting environment to encourage healing and create emotional and physical safety.

   Virginia lawmakers have a chance to reimagine what it means to put young people’s needs at the forefront of their decision-making during the 2023 General Assembly session. Between Governor Youngkin’s proposed budget and several budget amendments before the legislature, there are opportunities to ensure behavioral health services are available in every region and designed with the needs of children and youth in mind. This includes expanding crisis response services with components specific to children and youth and providing adequate resources to build the capacity of the system.

   TAKE ACTION: We urge lawmakers to prioritize young people’s healing and well-being. This can be done by making a targeted investment in youth mental health through the state budget.

   Build out crisis response and stabilization services that offer young people support when and where they need it.

   • Continue the expansion and modernization of the statewide crisis services system by investing in crisis receiving centers and crisis stabilization units. Hire a staff member to oversee Children’s Crisis Response Services.
     • Support the Governor’s proposed budget to increase funding for a comprehensive crisis services system | $58,345,204

   • Fund contracts with private providers to establish mobile crisis units in underserved areas.
     • Support the Governor’s proposed budget to provide one-time funds for mobile crisis units | $20 million

   Prioritize young people in the design and implementation of mental health services.

   • Build upon the base of $8.4 million the legislature has provided since SFY2017 to expand or enhance children’s behavioral health services in all five Department of Behavioral Health and Developmental Services (DBHDS) health planning regions and keep a dedicated focus on infrastructure specific to children and youth services within DBHDS’s Office of Child and Family Services.
     • Support budget amendments for Children’s Behavioral Health Services: Item 313 #1h (Price)/Item 313 #6h (Seibold); Item 313 #5h (Rasoul); Item 313 #3s (Favola)

2. General Assembly 2022: Mental Health Wrap-Up

   June 15, 2022 3:13 pm Leave a Comment

   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.

   Senator Jennifer McClellan has been a significant leader on school based mental health and increasing resources for school-based professionals. Read more in her Op/Ed in the Fredericksburg FreeLance Star.

   Addressing Workforce Shortages

   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.

3. General Assembly 2022: Child Welfare Wrap-Up

   June 8, 2022 11:41 am Leave a Comment

   The Foster Care system has been adversely impacted by the COVID-19 pandemic. In the last two years foster families have experienced greater financial stress, fewer foster parents have become trained, and turn over in the workforce has increased from already high levels. In some localities children have been sleeping in local department of social services offices while awaiting placement, resulting in the Governor calling a for a special “Safe and Sound” taskforce to address the urgent needs.

   We are encouraged by the final budget including many of the initial priorities for foster care that Governor Northam introduced in December. Beyond those policies, several new programs were funded targeting older youth in care  about to transition to adulthood. Ultimately, we still have a long way to go to properly fund our child welfare system.

   Here are the highlights of the budget for child welfare advocates:

   Investing in the Infrastructure of Child Welfare

   The instability of the foster care workforce and outdated technology are major challenges in Virginia’s child welfare system. According to a 2018 JLARC report, the quit rate for an entry-level Family Services Worker Specialist is 42%, with retention being an even greater issue in small, rural agencies.

   • 10% increase in staff and operations and Local Departments of Social Services over two years
   • $22 million for the replacement of the outdated child welfare data tracking system. Updated technology, along with updated training and child welfare courses, will allow social services to serve children and families more efficiently. This can reduce the length of time between a child entering foster care and finding permanent care through reunification, kinship care, or adoption.
   • $5 Million in mandated reinvestments to provide additional resources for ongoing mandated activities such as post adoption case management services, mutual family assessments, foster care and adoption services, and substance abuse services.

   Scale Up Evidence & Community-Based Practices to Achieve Better Outcomes for Children and Families

   • Funding to provide fidelity monitoring and evaluation of evidence‐based prevention services, appropriates federal Transition Act funding and fully funds salaries for allocated program position.

   Provide Social Supports & Easier Path for Kinship Caregivers

   • Funding for SB 396 provides that the court has the authority to review a foster care plan placement determination by a local board of social services
   • Funding for HB 653 Delegate Wampler which directs the Department of Social Services to establish and implement a collaborative local board placement program to increase kinship placements and the number of locally approved foster homes.
   • Increase to TANF Cash Assistance Allocation (impacts Kinship Families receiving child-only TANF) – 5% increase.

   Help Foster Care Youth Have Normal Adolescent Experiences

   Virginia continues to rank 49th in the country for youth in foster care aging out without a permanent connection. Investments in this area are desperately needed to support transition age youth.

   • Funding for the development of the iFoster Care Portal, a free internet resource that includes education assistance and workforce development options, as well as independent living resources geared for young adults who have experienced foster care.
   • $1 Million to develop a state-funded grant program providing a range of funding for the Great Expectations Program in the following areas: the hiring of college coaches or mentors, housing stipends, child care, and transportation needs.
   • Budget language directing the State Higher Education Council to examine the feasibility of having a point of contact at each public institution of higher education for students who have been involved in the foster care system.

   Supporting the Efforts of the Safe and Sound Taskforce

   After the budget was reconciled, Governor Youngkin introduced these budget amendments  recommended by the Safe and Sound Task Force which will continue to meet to address the current crisis in placement and the systems level changes needed to prevent children from entering foster care.

   • $592,120 for five positions to support the development of collaborative partnerships between local departments of social services (DSS) to increase capacity to approve kinship caregivers and recruit, train, and develop locally approved foster parents. This effort will support HB653, patroned by Del. Wampler, to facilitate collaboration between local DSS.
   • $1.1 million to create an enhanced treatment foster care pilot program, commonly known as the Professional Foster Parent Model. This program will serve foster homes caring for high acuity children and provide participating foster families with an annual stipend of up to $45,000 per youth.
   • $200,000 to cover the costs of coordination, recruitment, and additional training to foster care agencies.
   • $3,000,000 to support the initiatives of the Safe and Sound Task Force including community-based treatments, support for kinship, foster and adoptive families, and trauma-informed care for children in foster care who are displaced or who are at risk of being displaced.

4. General Assembly 2022: Health and Wellness Wrap-Up

   10:11 am 1 Comment

   Understanding the social determinants of health (SDOH) that impact children’s lives informs how we advocate for policies that improve the health and well-being of all children, especially children of color and economically disadvantaged children. During the 2022 General Assembly Session, Voices joined partners, advocates, and youth in asking lawmakers to invest in equity and provide access to language services across state agencies, healthy and nutritious foods, and comprehensive health care.

   After months of negotiation, the legislature has reached an agreement on the state budget, including many of these initiatives. Policy changes in legislation and budget language have made progress towards holistically addressing the inequities and disparities faced by Virginia’s children and families.

   Creating an Equitable Health Care System
   

   • HB 987, sponsored by Delegate Tran, was signed into law and requires the Board of Medical Assistance Services to ensure that all medical assistance program information provided to applicants is made available in a manner that is timely and accessible to individuals with limited English proficiency through language access services. This includes oral interpretation, written translations, and auxiliary aids and services for individuals with disabilities as a reasonable step to provide meaningful access to health care coverage.
   • HB 229, sponsored by Delegate Coyner, was signed into law and requires the Department of Health to collect and analyze information, including demographic data, regarding social determinants of health and their impact on health risks and health outcomes of Virginians.
   • To address Medicaid enrollment, language is included in the budget directing the Secretary of Health and Human Resources to establish a Task Force on Eligibility Redetermination. This task force will help plan and advise the Department of Medical Assistance Services on the unwinding process to ensure Virginians do not lose healthcare coverage. The language also adds American Rescue Plan Act (ARPA) funding to be used for operational challenges linked to eligibility redetermination, such as technology needs and paying staff overtime at local DSS agencies.
   • The legislature has directed $2.5 million in FY23 to continue the contract for an integrated e-referral system for one year. It is expected that the e-referral system will continue beyond FY23 with user fees supporting its operations. The purpose of the system is to connect government agencies, health care providers, and community-based partners to enable participants in the system to refer patients to public health and social services.

   Increasing Language Access and Equity
   

   • While the funding amount was reduced from the original budget, $2.5 million per fiscal year remains in the current budget to be provided to state agencies for facilitating and improving language access. This funding will allow each state agency to designate a language access coordinator who will be responsible for making sure that agency materials and communications are accessible to all Virginians, especially those who have limited English proficiency.

   Increasing Food Access and Nutrition Security

   • To ensure access to healthy and nutritious foods and boost the buying power of the Supplemental Nutrition Assistance Program (SNAP) benefit for fruits and vegetables at farmers markets and food stores, $1 million per fiscal year will be directed to Virginia Fresh Match.
   • HB 582, sponsored by Delegate Roem, was signed into law and requires public institutions of higher education to ensure that young people in college have access to information on SNAP benefits, including eligibility and how to apply. The bill also requires each institution to advertise information on the SNAP benefit process on their website and in orientation materials distributed to students.
   • HB 587, sponsored by Delegate Roem, was signed into law and requires every public elementary or secondary school to process web-based or paper-based applications for participation in the School Breakfast Program or the National School Lunch Program, administered by the U.S. Department of Agriculture, within five working days after the date of receipt of the application.

   Creating a future where Virginia’s children can thrive will require intersectional approaches, including equitable, healing-centered policies that dismantle systemic barriers so that all young people can lead long, healthy, and successful lives. While the budget takes important steps forward, we must continue uplifting youth voices to improve policies impacting their health and well-being.

5. General Assembly 2022: Early Education Wrap-Up

   June 6, 2022 12:50 pm 2 Comments

   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 21^st 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.

   Healthy Development

   • 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.

6. 2022 General Assembly Budget Passes with Bipartisan Progress for Kids

   June 3, 2022 9:54 am Leave a Comment

   Click here to register for our upcoming Zoom webinar on June 14 as we discuss General Assembly results and what they mean for children and families in Virginia.

   After several months of negotiations and discussions among key decision makers, the General Assembly has reached an agreement on the budget. This year’s budget had notable investments in early education, foster care, and children’s mental health through bipartisan support. Since budgets are a reflection of priorities, we believe there are improvements Virginia can make to demonstrate its commitment to young people in the commonwealth.

   Notable investments in the final budget compromise include:

   • Expanding affordable, accessible early childhood education for young children around the state. The budget builds on Governor Northam’s vision to expand early childhood programming and provides funding for regional initiatives in Southwest Virginia and early intervention services for infants and toddlers with developmental delays.
   • State funding for school-based mental health integration projects linking mental health services into schools. The legislature approved $2.5 million for school-based mental health projects as well as the first regional recovery high school in Virginia.
   • New initiatives to address long-standing challenges in the child welfare system include replacing the outdated child welfare data tracking system and the iFoster web-based portal for youth, expanded regional collaboration for foster placements, and additional support for foster youth seeking associate’s degrees to participate in Great Expectations.
   • $1 million each year to boost the buying power of SNAP benefits to purchase fruits and vegetables at farmers markets and community retailers.

   We are proud to stand by the youth and young adults who advocated with us for these investments. And we will continue to speak up for policy changes designed to meet their needs.

   As one of our youth advocates said,

   “Mental health is the same thing as your physical health. It’s just as important, if not more important, so we really need to prioritize that and make it so that everybody has equal opportunities.”

   – (Aaliyana, 16 years old).

   While these initiatives will continue to create new opportunities for young children to grow and thrive, the foundation of their success is economic stability. The rate of children experiencing poverty has remained consistent for decades in Virginia with persistent racial disparities in the percentage of Black and Latino children living in poverty than their White peers. A solid foundation for child well-being rests on a solid financial foundation for their families.

   As a significant commitment to families, the General Assembly approved a partially refundable Earned Income Tax Credit (EITC):

   • Low-income working families who have a higher-than-average tax burden will see 15% of the value of their federal refund returned as a state tax credit.
   • In addition, this summer, taxpayers will receive one-time rebates of $250 for single families and $500 for married couples.

   The refundable EITC for families demonstrates that lawmakers can take necessary action to address long-standing challenges for families that were exacerbated by the pandemic. There will be more work to do to ensure that families receive economic support and stability that will address decades-long trends in child poverty and ever-increasing material hardship experienced by families across the state.

7. Why Virginia Must Do Better for Black Mothers and Black Babies

   February 11, 2022 11:50 am 9 Comments

   Dr. J. Marion Simms is known as the founder of modern surgical gynecology. However, in the 1840s, Simms spent years conducting experiments on enslaved women. Their names are only known as Anarcha, Lucy, and Betsey. They were considered property and could not consent to the painful surgeries that were performed on them. In modern medicine today, numerous research studies name findings that shed light on explicitly bias beliefs that Black people have thicker skin and experience less pain. According to research by Sophie Trawalter, an associate professor of public policy and psychology at the Frank Batten School of Leadership and Public Policy, the U.S. Department of Health and Human Services reported Black and Hispanic people receive worse care on 40% of the department’s care quality measures.

   Research consistently describes experiencing childbirth as a significant event of great psychological importance in a woman’s life. Childbirth infinitely shapes a woman’s perception of themselves and may positively impact their relationships with other family members. However, literature only parallels the positive experience with a “well-supported, normal birth.” While healthy births are normalized, it is not taken for granted in Black communities. We have heard the horror stories of women who were not listened to by their doctors, which later resulted in death.

   My niece, Genesis, was born on January 27, 2022. When I heard my sister was pregnant, I first asked, “do you have a doula? Do you have a midwife?” Many credible sources have reported a now all too familiar data point. According to the Center for Disease Control (CDC), Black women in America are three times more likely to endure death related to pregnancy and childbirth than White women, regardless of their education or financial means. For women over 30, the risk is five times higher. The Virginia Department of Health reported the maternal mortality rate for Black mothers is more than double that of White mothers. A 2019 report by the Virginia Maternal Mortality Review Team noted 44 percent of pregnancy related deaths were due to a provider related factor, such as a failure to refer or seek consultation.

   The Fetal and Infant Mortality Review Team (FIMRT) Work Group Study reported Virginia’s rate of fetal death in 2019 was 7.6 fetal deaths per every 1,000 live births. While it was the lowest it has been since 2015, March of Dimes reported the infant mortality rate for Black infants was 9.5 per 1,000 live births in comparison to White infants at 4.8 per 1,000 live births in the state. (Diduk-Smith 8, 2021)

   In 2021, former Governor Ralph Northam released the Maternal Health Strategic Plan to eliminate racial disparities in maternal deaths by 2025. The plan appears to be no longer available on the server, yet stated, “Black women were more likely to report experiencing discrimination or harassment due to their race/ethnicity or insurance or Medicaid status.”

   People continue to name the conscious and unconscious biases that contribute to disproportionate outcomes for Black mothers and Black babies, some of which are so endemic it goes unnoticed. In 2021, an illustration of a Black fetus in a womb went viral.

   

   Illustration by Chidiebere Ibe, Forbes featured medical illustrator, medical student, and aspiring neurosurgeon

   Most fetuses are reported to be red in color or dark pink and gradually develop their skin tone; however, the medical demonstration was intended to represent patients who are not used to their skin tones in such images. The illustrator, Chidiebere Ibe, responded to the virality of his illustration in a statement on CNN, “the whole purpose was to keep talking about what I’m passionate about — equity in healthcare — and also to show the beauty of Black people…we don’t only need more representation like this — we need more people willing to create representation like this.”

   Black women are most impacted by maternal infant mortality disparities and it is also Black women leading the charge in dismantling them. In 2021, a Black woman, Delegate Lashrecse Aird led HJ 537, a resolution to recognize racism as a public health crisis in Virginia, making the state the first in the south to do so. The resolution included the recommendation to require training for elected officials, staff members, and state employees on how to recognize and combat implicit biases.

   This year, a Black woman, Dora Muhammad, Congregation Engagement Director and Health Equity Program Manager with the Virginia Interfaith Center for Public Policy, led the initiative to require medical practitioners licensed by the Board of Medicine to complete two hours of continuing education in each biennium on topics related to implicit bias and cultural competency. While I was grateful to witness the birth of my niece Genesis, the following morning I witnessed SB 456, sponsored by a Black woman, Senator Locke, fail to report out of the Senate Education and Health’s Health Professions subcommittee with only two supporting votes from Senator Hashmi and the bill patron herself. The House version, HB 1105, also sponsored by a Black woman, Delegate McQuinn, met the same fate through a voice vote by the Health, Welfare, Institutions Subcommittee Three. These bills could have led to greater outcomes for other Black mothers and Black babies. Instead, they were put off until the 2023 General Assembly Session.

   The Hippocratic Oath, “Do No Harm,” is the first commitment to becoming a doctor. While the data continues to point to disparities in maternal and infant health, there continues to be a lack of willingness to explicitly name, call out racism, or even acknowledge the possibility that racism could very much be a factor in healthcare disparities. For Black mothers, the fear of giving birth is valid. In 2020, the New York Times created a guide as a resource, Protecting Your Birth: A Guide For Black Mothers.

   While Black women continue to champion change, Virginia too must commit to doing better for Black mothers and Black babies.

    

   Resources

   Diduk-Smith, PhD, MPH, Ryan Marie. Rep. Report to the General Assembly Workgroup Study: Fetal and Infant Mortality Review Team (FIMRT) HB1950 of 2021. Richmond, VA : Office of the Chief Medical Examiner Virginia Department of Health, 2021.

   Humenick, Sharron S. “The Life-Changing Significance of Normal Birth.” The Journal of Perinatal Education. U.S. National Library of Medicine, 2006. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1804308/.

   “Infant Mortality Rates by Race/Ethnicity: Virginia, 2016-2018 Average.” Peristats | March of Dimes. Accessed February 10, 2022. https://www.marchofdimes.org/peristats/ViewSubtopic.aspx?reg=51&top=6&stop=92&lev=1&slev=4&obj=1.

   Hobron, Kathrin ‘Rosie. “Annual Report 2017 – Virginia Department of Health.” Office of the Chief Medical Examiner Annual Report 2017. Virginia Department of Health, 2017. https://www.vdh.virginia.gov/content/uploads/sites/18/2019/04/Annual-Report-2017.pdf.

   Rouse, Melanie J. “Chronic Disease in Virginia Pregnancy Associated Deaths …” Chronic Disease in Virginia Pregnancy Associated Deaths, 1999-2012: Need for Coordination of Care, 2019. https://vdh.virginia.gov/content/uploads/sites/18/2019/08/MMRT-Chronic-Disease-Report-FINAL-VERSION.pdf.

   United States Department of Human Services. “Racial and Ethnic Disparities Continue in Pregnancy-Related Deaths.” Centers for Disease Control and Prevention. Centers for Disease Control and Prevention, September 6, 2019. https://www.cdc.gov/media/releases/2019/p0905-racial-ethnic-disparities-pregnancy-deaths.html.

8. Tax Credits Provide Essential Financial Relief to Working Families: Tell Lawmakers to Act

   January 26, 2022 10:57 am Leave a Comment

   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

   Refundable State Tax Credits in 2022 and Beyond

   Another issue the legislature will consider this year is whether to make our state Earned Income Tax Credit (EITC) partially refundable so that it can be returned to families with their state tax rebate. Approximately 72% of all tax filers who benefit from the EITC have children, so creating a refundable portion would impact over one in three children in Virginia.

   In his outgoing budget proposal, Governor Northam proposed to make the state’s Earned Income Tax Credit (EITC) partially refundable for working families with low and moderate incomes. Voices is a member of the Virginians for Tax Fairness Coalition led by The Commonwealth Institute and New Virginia majority. As a member of that coalition, we support two bills under consideration in the Virginia House and Senate for a refundable EITC: Senator Barker’s SB343, Senator McPike’s SB515; Delegate Price’s HB1312.

   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.

   Read more about how state lawmakers’ tax policy choice could impact families and state revenues from The Commonwealth Institute.

9. Voices’ Youth Advocacy Day Recap

   January 21, 2022 11:30 am 3 Comments

   (Pictured above: Cohort members and Voices’ staff take a “before” picture before embarking on their legislative meetings.)

   “Keep going. Don’t ever stop. Don’t ever let anybody silence your voice. Don’t ever let you silence your voice. Understand the importance of what you do… Keep pushing, because one day it will really pay off.” – Jonathan, 15 years old, from Hampton, VA

    

   Our 2022 Advocacy Cohort completed their Youth Advocacy Day on Tuesday, January 18, 2022. Fifteen youth and young adults, ages 14 – 25, divided into four small but mighty groups to meet with fifteen policymakers (a combination of Delegates and Senators) throughout the afternoon. Advocates presented on key issues impacting themselves and their communities such as the state of youth mental health, improvements for the foster care system, needed supports and protections for LGBTIQIA+ youth, and equitable access to health coverage.

   “I talked about being trans and the discrimination that LGBTQ kids face in schools, and the fact that we endure so much… People are really hateful and spiteful and say horrible things… I’ve been asking for there to be some sort of set punishment and just understanding of why [these protections] are so important.” – Grace, 14 years old

   “Whether we’re fighting for health care or mental health services or more inclusive classrooms or more inclusive language or anything of that nature, my main thing was just making sure that we’re considering our young people every step of the way, because the choices that our policymakers and legislators make today, we’re gonna have to deal with tomorrow.” – Elijah, 14 years old

   

   (Pictured above: Several cohort members and Voices’ staff meet with Del. Conyer.)

   “Mental health is the same thing as your physical health. It’s just as important, if not more important, so we really need to prioritize that and make it so that everybody has equal opportunities.” – Aaliyana, 16 years old

   “I talked about how bullying is equated to hate crimes at the moment and how that’s just unacceptable because they are two very different things. I asked a lot of the people we spoke with to start building [more protective] systems into schools.” – Chanel, 19 years old

   

   (Pictured above: Cohort members presenting to Sen. McClellan’s office with Voices’ Chief Policy Officer, Emily Griffey.)

   “There’s just a lack of help… because of language access. I also talked about health insurance and… the human right to just being able to access [medical and mental health treatment].” – Naomi, 17 years old

   

   (Pictured above: Cohort members advocate for youth mental health support with Del. Delaney.)

   

   (Pictured above: Advocates meeting with Sen. Mason’s offices with Voices’ Policy and Programs Director Allison Gilbreath.)

   Originally scheduled to be a series of in-person events and legislative meetings, the cohort quickly pivoted in response to the surge in COVID-19 cases and worked together to support and encourage one another throughout the virtual advocacy day. Cohort participants worked with Policy Team members to practice storytelling and connecting their experiences to policy and upcoming legislation.

   This group of changemakers left legislators and the Voices’ team completely inspired, moved, and awe-struck. We know their courageous storytelling is making incredible impact and we were honored and humbled to support them on their advocacy journeys.

10. Increasing Language Access & Equity in Virginia

    11:16 am Leave a Comment

    Virginia is home to speakers of many languages. However, the access to language services are inconsistent across the state varying from agency to agency. Without these consistencies, there are no statewide guidelines to ensuring limited English proficient (LEP) individuals can get access to the adequate services they need. According to Voices for Virginia’s Children:

    • 1 in 4 children are immigrants or living in an immigrant family;
    • 1 in 5 children in Virginia speak a language other than English;
    • 44,000 children may require language access services;

    Languages most often spoken by speakers with limited English proficiency in Virginia include Spanish, Korean, Vietnamese, Chinese, Hindi, and Arabic. Title VI of the Civil Rights Act of 1964 and Executive Order 13166 requires recipients of federal financial assistance to take reasonable steps to make their programs, services, and activities accessible to individuals who are eligible with limited English proficiency.

    In April 2021, the Virginia Department of Health published instructions for English-speaking readers stating the COVID-19 vaccine “will not be required for Virginians.” However, the Spanish-language translation conducted through a Google Translation widget stated, the COVID-19 vaccine, “no sera necesario,” or will not be necessary. Notably, Virginia may have further exacerbated disparities minority communities were already facing. While the public was encouraged to seek credible information, the state failed to ensure it was comprehensive to all.

    During the 2021 special legislative session, $500,000 was included in the budget for a language access translation planning consulting services report, which highlighted 3 in 4 state agencies could not meet LEP speaker needs most of the time. These kinds of barriers have been exacerbated by the urgent needs of the pandemic, which makes an already lengthy process, such as getting access to unemployment in Virginia even lengthier for speakers who are LEP.

    Three bills have been introduced during the Virginia General Assembly Session to increase language access and ensure every family is able to gain access to the information and services they need, including their health care options. Each bill focuses on supporting language access for the following areas:

    • (SB 270 & HB 1049) – all state agencies (services provision and administration);
    • (HB 987) – a Department of Medical Assistance Services (DMAS) bill that will specifically impact Medicaid in the state code and will address that part of the code;
    • (SB 245) – DMAS, and medical debt.

    In addition to language access, the medical debt bill includes critical provisions to ensure linguistically marginalized communities in Virginia (LMCs) understand their medical bills, know their rights to medical debt assistance, and receive essential information in-language.

     SB 270 & HB 1049 notably establishes basic principles so that all Virginians are able to access state agency services feasibly; the legislation

    1. Requires each state agency to adopt a language access policy (implementing the Commonwealth’s policy) by November 1, 2023. 
    2. Requires each agency to designate a language access coordinator who will be responsible for developing and implementing the agency’s language access policy and preparing the agency’s annual language access report. 
    3. Establishes an Interagency Working Group on Language Access that will develop a model language access policy for adoption by state agencies and will make recommendations for policy and funding changes to ensure language access needs, particularly for populations who do not speak one of the 10 major foreign languages.
    4. Requires Secretary of Administration to establish criteria for the procurement of language interpretation and translation services by state agencies and determine qualifications of and compensation for state employees who are multilingual and are required as part of their job to provide interpretation, translation, or other bilingual skills at least once a month.
    5. Codifies Virginia agencies’ Title VI obligations.

    Since 2006, at least 43 states have enacted law(s) addressing language access in healthcare settings. Virginia has the opportunity to join others and further lead. 

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