On Thursday, the House of Representatives went on recess without passing a single funding bill—just 10 days before the federal government is scheduled to run out of money. Speaker of the House Kevin McCarthy (R-Calif.) tried and failed twice last week to pass a defense spending bill, all with the hope of building momentum in the chamber to pass a short-term continuing resolution that would fund the entire government. His latest overture to the hard-right members of his caucus included an 8% reduction in domestic spending, more stringent immigration laws, and establishment of a fiscal commission to recommend changes to entitlement spending. His proposed spending level was $1.526 trillion, $64 billion less than what he agreed to with President Joe Biden earlier this year and a non-starter in the Democratic-controlled Senate.

Despite these concessions, members of the far-right scuttled the defense spending bill, sending the entire process into chaos. With time ticking toward the Sept. 30 deadline, it is unclear how Speaker McCarthy intends to pick up the pieces and avoid a disastrous government shutdown that, by some estimates, would cut GDP by 0.2 percentage points for each week in duration and could force the economy into a recession.

Democrats Introduce Bill to Save Child Care

On Sept. 13, leading Democrats in the Senate and House of Representatives introduced the Child Care Stabilization Act, which would fend off an impending catastrophe in the child care sector by funneling money to providers. The bill, co-sponsored by Sens. Patty Murray (D-Wash.) and Bernie Sanders (I-Vt.) and Representative Kathryn Clark (D-Mass.), would dedicate $16 billion per year in mandatory funding for the next five years to child care providers, keeping the sector afloat after a series of tumultuous years during and after the pandemic. On Sept. 30, $24 billion in stabilization assistance, which has been a lifeline to the sector, is set to expire.
According to one analysis from The Century Foundation, if no additional funding is found, 70,000 child care programs would shutter, 3.2 million children would lose care, 232,000 workers would be out of jobs, and states would lose $10.6 billion in tax and business revenue. The Child Care Stabilization Act would continue this much-needed funding stream and ensure child care centers can provide high-quality and affordable child care.

HUD Announces New Awards to Tackle Youth Homelessness

On Sept. 20, The Department of Housing and Urban Development announced $60.3 million in awards for efforts to end youth homelessness in 16 communities. The program, called the Youth Homelessness Demonstration Program, funds a variety of services depending on local needs, including rapid rehousing, host homes, and transitional housing. During the awards process, HUD engaged youth who had experienced homelessness, eliciting their feedback on applications.

Award recipients will use the funds to tackle their communities’ unique challenges, with a special focus on equitable approaches to disproportionately affected groups, including BIPOC, LGBTQIA+, and differently abled youth. Each community is required to create Youth Action Boards, which are led by youth with lived experience and strive to design and improve programs. In total, 110 communities have received $440 million through the Youth Homelessness Demonstration Program. In preparing this round of recipients, HUD worked closely with the Department of Health and Human Services, the Department of Education, and the U.S. Interagency Council on Homelessness to support development of the program. YHDP is part of the Biden-Harris Administration’s All In initiative, which seeks to reduce homelessness by 25% by 2025.

New Initiative Focuses on TANF and Child Welfare Collaboration on Prevention

The Office of Family Assistance and the Children’s Bureau, within the Administration for Children and Families, announced a joint initiative called Families Are Stronger Together (FAST), which will create a new Temporary Assistance for Needy Families (TANF) learning community built around collaboration between TANF and child welfare agencies, with a special focus on prevention. Because one of TANF’s goals is to ensure children are supported in their own home or in the home of relatives, TANF has a large role to play in providing economic assistance to struggling families. The learning community will develop new strategies for coordination between TANF and child welfare agencies that support families and prevent poor outcomes for children. Over the 12-month initiative, 10 teams made up of TANF and child welfare agencies from different states will work with coaches, attend in-person gatherings, and receive technical assistance.

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On Aug. 30, the U.S. Department of Labor (DOL) proposed a new rule that will directly impact overtime pay policies in the social sector. The social sector must have a seat at the table as the Department considers implementing its changes.

The Fair Labor Standards Act (FLSA) mandates minimum wage and overtime pay for eligible employees. An exemption known as the “white-collar,” or executive, administrative, or professional (EAP) exemption exists for certain employees, which is subject to specific criteria set by the DOL.

The proposed changes to the EAP exemption include:

The proposed changes aim to better define who qualifies for the EAP exemption by aligning salary levels with contemporary wage data. These updates are based on the DOL’s commitment to regularly review and adjust salary thresholds to keep pace with changing wages.

The Department estimates these changes could affect 3.4 million employees who would gain overtime protection and 248,900 employees affected by the HCE total annual compensation increase. The estimated direct employer costs over the first ten years would be $664 million, with $1.3 billion in annualized income transfers from employers to employees.

The proposed adjustments to the EAP exemption aim to ensure it remains relevant and effective in distinguishing between exempt and nonexempt employees while considering economic impacts on employers and employees.

Here are relevant resources to better understand the new rule:

Please read these resources and learn how it would impact your organization.

The DOL has opened the new rule to public comment for 60 days. Social Current is seeking feedback from the network to inform our response, which we will submit to the DOL by the deadline on Halloween. We also encourage network organizations to submit their own comments.

Please get in touch with our Government Relations Team at babelle-kiser@social-current.org and dkiernan@social-current.org with questions or feedback on the rule.

You can also submit feedback through this form.

New Nonprofit Workforce Shortage Crisis Report from NCN

The National Council of Nonprofits recently released its annual report 2023 Nonprofit Workforce Survey Results: Communities Suffer as Nonprofit Workforce Shortage Crisis Continues. The report, based on 1,600 survey responses from all 50 states and the District of Columbia in April, paints a stark picture of the social sector struggling to recover from the pandemic. Nearly three quarters of respondents reported job vacancies in their organizations, with 75 percent of respondents citing vacancies in program and service delivery positions, and 41 percent in entry-level positions. Almost 52 percent said they have more vacancies than before the pandemic, and 28 percent said they have longer waiting lists for services. The main staffing challenges are related to salary competition and budget constraints. 72 percent of respondents cited competition with other sectors as a barrier to recruitment and retention, and two-thirds referred to budget constraints/insufficient funds as a significant issue. About half of respondents named stress and burnout as an obstacle. Ominously, over 70 percent of nonprofits expect less or the same level of charitable giving in 2023.

The survey also asked respondents to mention solutions to the staffing difficulties they are facing. Four policy solutions topped the list, including reform of government grants and contracts, implementation of charitable giving incentives, support for the Public Service Loan Forgiveness Program, and funding for child care.

Possible Government Shutdown

With the deadline to pass the federal budget by Sept. 30 rapidly approaching, lawmakers in Congress are desperately trying to cobble together a continuing resolution that would avoid a debilitating government shutdown. Only three out of the twelve bills that constitute the federal budget are even close to passage in the Senate, and the House is nowhere near passing a single bill. Leaders on both sides of the aisle have agreed that a continuing resolution, which would fund the government at current levels for a short period of time, is necessary to buy time to reach a deal on the FY 2024 budget.

However, stark disagreements have emerged over supplemental funding for Ukraine and disaster aid many wish to see attached to the continuing resolution. The Senate supports President Joe Biden’s request for $24 billion in aid to Ukraine, but members of the House GOP are pressuring House Speaker Kevin McCarthy (R- Calif.) to drop it. In response, McCarthy is considering exchanging Ukraine aid for stricter border policies on immigration and asylum that the Freedom Caucus supports. Theoretically, McCarthy has enough votes from House Democrats and moderate Republicans to pass a clean resolution; however, he has felt intense pressure from far-right caucus members to give in to their demands.

Ultimately, a government shutdown would be disastrous for the country, as job growth slows, interest rates rise, and policymakers work to avoid a recession.

HHS Proposes New Rule to Bolster Anti-Discrimination on the Basis of Disability

On Thursday, the Department of Health and Human Services proposed a rule that would strengthen anti-discrimination provisions for people with disabilities. Section 504 of the Rehabilitation Act of 1973 prohibits discrimination on the basis of disability in access to health and human service programs that receive federal assistance. The rule would update and clarify Section 504 in light of the changing legal landscape of disability discrimination. It would prohibit medical professionals from using stereotypes and biases about individuals with disabilities, as well as judgments about their value and burden on others, as bases for making medical decisions. The proposal would also create enforceable standards for accessible medical equipment and require access to integrated, community-based settings when appropriate for people with disabilities. Finally, the rule clarifies non-discrimination provisions in the child welfare space, when it comes to areas, such as parent-child visitation, child removals and placements, as well as foster and adoptive parent assessment. The public has 60 days to register comments on the rule.

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A recent study from Deloitte Research Center revealed workforce well-being has continued to decline since last year, leaving more employees feeling exhausted (52%), stressed (49%), and overwhelmed (43%). In fact, a significant percentage of employees say their job has negatively impacted their physical (33%), mental (40%), and social (21%) well-being.

“Executives have an opportunity to rewrite this story—for their employees, for their managers, and also for themselves. Work shouldn’t be the reason people feel exhausted, stressed, and isolated from friends and family,” notes this article about the study. “Employees should feel that they’re able to take time off and disconnect, and managers should feel capable of providing the support their team members need.”

Despite these alarming trends, the study also identifies solutions for supporting a healthy, thriving workforce:

“Human sustainability” is defined by the study as the “creation of value for current and future workers and, more broadly, human beings and society.” According to Deloitte, 82% of employees report they would be more likely to take a job that is advancing human sustainability.

Though working in human services can be particularly challenging, organizations can tap into people’s desire to be connected to a greater societal purpose by keeping them connected with and engaged in their mission and impact.

How Social Current’s Work Aligns with Findings

Social Current’s workforce resilience approach is based on four core learning concepts that are deeply rooted in equity and brain science for long-term organizational impact. This approach works to enhance and embed human sustainability at the individual, organizational, and collective levels by:

Advancing Brain Science and Regulation

Deloitte’s study revealed a lack of capacity for workers, managers, and executives to accomplish their workloads while remaining accountable for their personal and organizational well-being. Social Current’s approach to workforce resilience uses brain science to offer tangible tools for increasing regulation, allowing for increased connection, accountability, and trust.

Building Psychological Safety

The practice of psychological safety is built into the workforce culture over time and requires leaders to respond to staff challenges by modeling authenticity, accountability, and compassion, creating space for sharing and listening. Deloitte’s study, however, revealed that although most managers (73%) believe they should be modeling healthy behavior, they do not feel empowered to do so (42%). Social Current’s experts provide guidance to empower organizational leaders to embrace and embody these concepts.

Prioritizing Positive Workplace Culture

This year, 60% of employees and 75% of executives were considering quitting their current jobs in search of better well-being outcomes. Resilience at work is highly dependent on a positive culture that reflects the organization’s stated values and beliefs. Social Current’s approach makes culture a priority to prevent and mitigate workforce concerns such as secondary traumatic stress and burnout.

Increasing Connection

Nearly a third of employees reported feeling like their manager did not care about their well-being in Deloitte’s study, and only 35% of managers reported being open about their well-being with their employees. We are hardwired for connection, and an organization is more likely to thrive when employees feel connected. Social Current’s approach models practices, such as frequent check-ins, peer mentors, normalizing discussions around mental health and EDI, and finding shared purpose to build meaningful connection.

If you are ready to take accountability for your organization’s workforce well-being, contact us to learn more about next steps, or register for our upcoming four-part “Building a Resilient Workforce” webinar series.

On Tuesday, the Biden administration began accepting applications for a new student debt program called SAVE (Saving on a Valuable Education). This income-driven repayment plan will determine monthly payments based on income and family size, rather than loan balance. The administration says that many eligible borrowers will pay nothing in monthly payments, while others will save about $1,000 per year. These individuals will pay about 5% of their discretionary income, down from 10% previously. This low-income repayment plan comes after numerous recent setbacks for the administration in their work on student debt relief. As part of the budget deal with House Republicans earlier this year, the administration agreed to end the pandemic-era pause on student loan payments by Oct. 1. Furthermore, the Supreme Court shot down the administration’s far-ranging student debt relief plan earlier this summer. The SAVE program is another attempt by the Biden administration to help borrowers in need. According to the administration, it has cancelled $116 billion in student loan debt held by 3.4 million Americans.

Federal Budget Negotiations Roll On

This week, Speaker Kevin McCarthy told House Republicans that Congress will likely need to pass a stopgap bill, also known as a continuing resolution. Senate Majority Leader Chuck Schumer confirmed Wednesday that he and McCarthy had recently agreed to pursue the resolution, a short-term government funding bill that could help Congress avoid a shutdown. When members of Congress return in September from their month-long August recess, there will be just a few weeks left to decide on spending bills if no resolution is passed. The continuing resolution would keep the government funded past the Sept. 30 deadline, giving the Democrat-led Senate and the Republican-led House more time to decide on the 12 spending bills that constitute the federal budget.

Congress must resort to a continuing resolution even though President Biden and Speaker McCarthy agreed earlier this year to a budget deal that would fund the government for an entire fiscal year. Since then, House Republicans proposed a budget that is $100 billion less than the brokered deal, while the Senate proposed spending $13 billion more. Leaders of both parties are urging their caucuses to drop unrealistic provisions and come to a compromise. Congress will hopefully overcome this impasse by the expiration of the continuing resolution, perhaps around Christmas. Social Current will continue to monitor the negotiation process and advocate for appropriations that are of vital interest to the social sector.

HHS Announces New Funding for Mental Health

On Aug. 23, the Department of Health and Human Services dispersed over $64 million in funding to help communities deal with the national mental health crisis. $59.4 million was made available as part of the $250 million for FY 2022-2025 in the Bipartisan Safer Communities Act, which Congress and President Biden signed into law last year. Health and Human Services Secretary Xavier Becerra said, “With these critical investments, states and territories will be able to continue to serve as an invaluable safety net for mental health services for some of the nation’s most vulnerable populations, including those impacted by gun violence, disasters, and other emergencies.” The remaining $5 million in awards will support Mental Health Awareness Training grants, which provides training for individuals and communities in responding appropriately to people with mental health challenges. These grants will help first responders, teachers, and others care for people with mental health or substance use challenges and refer them to appropriate service providers.

HHS Reports Inflation Reduction Act Reduces Health Care Costs

The Department of Health and Human Services announced that, with the passage of the Inflation Reduction Act (IRA) on Aug. 16, 2022, millions of consumers are already spending less on health care. The IRA extended subsidies for health insurance purchased on HealthCare.gov and state-based marketplaces, which led to a record enrollment of 16.4 million people during the 2023 open enrollment period. Of all signups, 90% are receiving subsidies toward their monthly premiums. The IRA also made significant changes to Medicare. Monthly insulin payments are capped at $35, saving 1.5 million seniors an average of $500 per year compared to costs in 2020. Also, more vaccines are available cost-free, including shingles, and hepatitis A and B. Finally, the IRA will implement a new out-of-pocket cap on prescription drugs in 2024, which will drop to $2,000 annually in 2025, saving almost $400 per year for more than 18.7 enrollees in Medicare Part D.

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Social Current announced today that Arabella Pérez, DSW, MSW has joined the organization as Chief Operating Officer. Social Current is a network of more than 1,800 human/social service organizations and partners that work to support, elevate, and expand the work of the social sector through collaboration, innovation, policy, and practice excellence.

Dr. Pérez is a licensed clinical social worker of 30 years and former board member of Social Current and the Council on Accreditation (COA). Prior to joining Social Current, Dr. Pérez was the vice president of diversity, equity, and inclusion (DEI) for the National Association of Social Work and a social work professor at the University of New England. From 2005-2015, she served as a system of care director, leading three grant projects for the state of Maine funded by the Substance Abuse and Mental Health Services Administration (SAMSHA). She is the founder and former chief executive officer of THRIVE, a nonprofit, technical assistance center for trauma- and culturally informed care. Additionally, she is a graduate of the Hanley Leadership Program and was named a teaching scholar on justice, diversity, equity, and inclusion for the Maine Educational System.

Dr. Pérez is a certified cultural competency educator and has consulted with states and communities on the development of behavioral health systems through federal site monitoring and coaching for SAMHSA. Her private consultation practice has focused on leadership and trauma-informed organizational change management in the private and not for profit sectors. She is a sought-out presenter and has published on the topic of trauma-informed care and culturally empowering education. She received her MSW and DSW from Tulane University.

“Dr. Pérez brings a passion for our mission and a demonstrated track record of social sector excellence to her work at Social Current as our inaugural COO,” commented Jody Levison-Johnson, president and CEO of Social Current. “Her efforts to promote systemic change and experience providing technical assistance in equity, diversity, and inclusion and trauma-informed care aligns perfectly with our mission and vision to ignite change for an equitable society where all people can thrive.” “I am excited to join an organization of people who are committed to making positive and lasting impacts in our communities,” commented Dr. Pérez. “I look forward to working together with the staff and management team at Social Current to tackle major social issues and to work collaboratively across the social sector with our many partners and colleagues.”

The Biden administration has begun publicly pressuring states to reevaluate internal processes that are leading to massive decreases in health care coverage across the country. In April, states started to make determinations about whether beneficiaries enrolled in Medicaid during the pandemic could stay in the program – a process known as Medicaid unwinding. According to the Kaiser Family Foundation, almost 4.3 million people have lost Medicaid coverage since April, and 74% of disenrollments occurred for procedural reasons, like failure to fill out paperwork in a specific timeframe, rather than ineligibility based on income. There are widespread concerns that many beneficiaries abandon attempts to re-enroll due to long wait times at call centers, language barriers, and arduous bureaucratic processes that states force them to go through. Last week the Centers for Medicare and Medicaid Services (CMS) sent letters to states asking them to address procedural challenges that are stopping eligible people from continuing coverage. The letters recommended states make call center enhancements, use non-English language materials, and opt for automatic over manual renewals. CMS also urged states to implement ex parte renewals, which draw data from sources like the Internal Revenue Service, Social Security, and the Supplemental Nutrition Assistance Program, to confirm income eligibility, rather than waiting for paperwork from beneficiaries.

FDA Approves Pill to Treat Postpartum Depression

On August 4, the Food and Drug Administration approved the first pill meant specifically to treat postpartum depression. The pill, Zurzuvae, is taken once daily for 14 days to treat severe depression following pregnancy, a condition that affects about 1 in 7 new mothers. The pill could be commercially available as soon as October and appears to provide more immediate relief than antidepressants. While the cost is not yet known, experts call it a “hopeful step forward” in making treatment more accessible. Currently, the only other FDA-approved treatment on the market is a $34,000 IV treatment.

Treating postpartum depression can prevent child fatalities and advance child safety and development. Social Current’s efforts to improve child welfare, such as the establishment of the Within Our Reach office, reflect the importance of parental mental health treatment in promoting child safety. This includes recommendations for postpartum depression screening to be conducted at pediatric appointments, a practice that could now lead to mothers being diagnosed and offered a more accessible treatment if Zurzuvae proves to be successful.

President Biden Touts Value of CCBHCs

In recent weeks, President Biden has been boosting mental health care. After proposing new rules that would reinforce the Mental Health Parity and Addiction Equity Act and ensure equal access to both mental and medical benefits, the president addressed the role that Certified Community Behavioral Health Clinics (CCBHCs) play in eliminating barriers to mental health care. In remarks from the White House, Biden said, “These clinics provide a range of services, including crisis support available 24 hours a day and seven days a week, and they serve anyone who needs care, regardless of ability to pay.” In the six years since the first CCBHC opened, over 500 others have sprouted up across the country, offering access to mental health care for low-income communities. CCBHCS work in tandem with the new Crisis and Suicide Lifeline, immediately connecting people in crisis to care. In addition to the impact of health and well-being, CCBHCs led to the creation of 11,000 new behavioral health jobs across the country.

DOE Audit Finds Room for Improvement in Charter School Grant Oversight

An audit released on Aug. 3, entitled “The U.S. Department of Education’s Processes for Overseeing Charter Schools Program Grants to Charter Management Organizations for the Replication and Expansion of High-Quality Charter Schools,” aimed to assess whether the U.S. Department of Education supervised grants in such a way as to ensure accurate annual performance reports and program spending in line with grant requirements. The Department and the Charter School Programs (CSP) office had designed processes to ensure accurate grantee reporting and proper fund utilization. Generally, these processes were followed, but there were shortcomings. For example, the CSP office failed at times to comprehensively fill out Academic Performance Review (APR) forms or communicate concerns with grantees, leading to less than reliable data. The CSP office also lacked proper record-keeping, resulting in the inability to locate a significant number of APRs.

The audit recommends that the Assistant Secretary for Elementary and Secondary Education take several actions:

  1. Monitor CSP program officers to ensure accurate completion of APR review templates and effective communication with grantees about issues.
  2. Implement procedures to complete corrective action plans, detailing recommended actions and their implementation by grantees.
  3. Establish a system for retaining records that demonstrate grantee compliance with corrective actions for fund usage issues.

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Social Current’s Strategic Industry Partners offer specialized products or services to benefit our network. We are proud to spotlight our Gold Strategic Industry Partner Your Part-Time Controller. (YPTC).

For over 30 years, YPTC helps to build stronger nonprofits. With over 1,400 nonprofit clients from coast to coast, YPTC assists with their financial management needs—from internal, grant, and board reporting, to forecasting, budgeting, and cash flow management, and from bookkeeping and monthly financial statements to the development of customized dashboards.

How YPTC’s Services Benefit the Social Sector

At YPTC, they help to build stronger nonprofits, one accounting department at a time. They provide the accounting and financial management services that help chief executives and board members in the social services sector determine how effectively and efficiently their organization is accomplishing its mission and provide them with the timely, accurate information needed for decision making.

YPTC Services

  • Accounting and month-end close
  • Financial reporting
  • Analysis and recommendations
  • Data visualization
  • Scenario planning and cash flow forecasting
  • Board meeting attendance and training
  • Policies and procedures
  • Forecasting
  • Budgeting
  • Grant proposals and ad hoc reports
  • Grant management
  • Audit turnaround
  • Federal awards grant writing and tracking

Why YPTC Partners with Social Current

“YPTC works with many types of social service organizations, whose missions are important to the communities in which we serve, and to our staff who serve them,” said YPTC Manager Sandra Magri. “Social Current works to strengthen the social services sector. YPTC partnering with Social Current makes perfect sense!”

Free Webinar from YPTC: Budget Essentials for Everyone

Ensure your organization is ready for budget season. Invite your program directors and department heads to join YPTC to see the their free webinar Budgeting for Impact: Nonprofit Budget Essentials.

Visit the YPTC website for news, webinars, and resources and to work with them.

Meet YPTC in person at SPARK 2023, Oct. 16-17 in Bethesda, Maryland.

To learn more about partnering with Social Current, please email us.

Last Wednesday, the Senate Committee on Homeland Security and Governmental Affairs marked up the Streamlining Federal Grants Act of 2023, which was introduced by Sens. Gary Peters (D-Mich.), James Lankford (R-Okla.), and John Cornyn (R-Texas) on July 17. In his introductory remarks, Sen. Peters thanked Sens. Lankford and Cornyn for their hard work on the bipartisan bill. He lauded the bill’s potential to help nonprofits apply for and manage grants, reduce government waste, and promote language access. After a series of amendments were introduced and voted down, the bill passed out of committee, clearing the way for a vote before the entire Senate in the months to come.

Social Current has been a strong and outspoken champion of the bill, which would simplify the grant application process for the social sector, particularly nonprofits, which face the most challenges in applying for grants. After the bill’s introduction, Social Current President and CEO Jody Levison-Johnson said:

“I am thrilled to see the introduction of the Streamlining Federal Grants Act of 2023 in the Senate, which reflects in part the Relief4Charities policy asks to strengthen and support the nonprofit sector. This legislation will greatly improve access to federal grants for underserved communities and streamline the application process.”

The bill would create a Grants Council with representatives from all federal grantmaking agencies, which would guide reforming complex and outdated procedures. Proposed reforms include everything from streamlining the application, administrative, and reporting processes to enhancing user experiences and soliciting grantee feedback. The legislation also requires federal agencies to seek input from non-federal agencies, including nonprofits, in the development and implementation of their agency plans. Finally, funding opportunities will be required to provide short, clear, and accessible summaries, so that potential applicants can readily understand them.

Social Current will continue to advocate for the passage of the Streamlining Federal Grants Act of 2023 and to keep the network updated on its progress through congressional negotiations.

Learn more about the legislation’s provisions that benefit charitable nonprofits in this one-pager from Social Current and the National Council of Nonprofits.

Institutions for Mental Disease (IMD) Compromise Passes the Energy and Commerce Committee

On July 19, the House Energy and Commerce Committee voted unanimously to pass H.R. 4531, the Support for Patients and Communities Reauthorization Act. The bill included a compromised version of H.R. 4056, the Ensuring Medicaid Continuity for Children in Foster Care Act, which would grant federal Medicaid coverage to children in foster care receiving treatment from Qualified Residential Treatment Programs (QRTPs) classified as Institutions for Mental Disease (IMDs).

A QRTP is typically classified as an IMD if it has over 16 beds. Currently, states cannot receive federal Medicaid payments for services provided to individuals in an IMD setting. This means that while a Medicaid-eligible child in an IMD does not lose their Medicaid benefits, states must bear the total cost. The classification of large QRTPs as IMDs aims to discourage congregate care for foster children and encourage states to increase the use of family and foster family care, which has been shown to have significantly better outcomes for children.

H.R. 4056 aimed to remove this IMD exclusion for children in foster care and allow states to draw from federal Medicaid funds to pay for their treatment while in a QRTP, regardless of whether it is classified as an IMD. The compromise, Sec. 304, would permanently lift the IMD exclusion for substance use disorder and permit QRTPs to bill Medicaid for health care services outside these facilities’ walls. Essentially, the compromise allows QRTPs to bill Medicaid for the treatment a child receives elsewhere, such as doctor appointments, but still does not allow a QRTP to use federal Medicaid funds to pay for in-house treatment provided by the QRTP. While Reps. Gus Bilirakis (R-Fla.) and Kathy Castor (D-Fla.), sponsors of H.R. 4056, both made it clear that they do not believe this compromise goes far enough to support QRTPs, they described the move as a step forward.

HHS Proposes New Rules to Achieve Parity for Mental Health Care

On July 25, the U.S. Department of Health and Human Services proposed new rules to ensure people seeking coverage for mental health care and substance abuse disorder can access these services as quickly and affordably as people can access coverage for medical treatments. The Mental Health Parity and Addiction Equity Act was enacted in 2008 and built on the Mental Health Parity Act of 1996 to lessen the barriers faced by those seeking mental health care. However, these barriers still exist 15 years later. To combat illegal restrictions on mental health and substance abuse treatment benefits, the U.S. Department of Health and Human proposes that plans and issuers make NQTL (Non-Quantitative Treatment Limitations) comparative analyses available to the Department of Treasury, the Department of Labor, the Department of Human Services, and eventually to Congress. If enacted, these new rules would be added to the Mental Health Parity and Addiction Equity Act and ensure plans and issuers are not putting unnecessary barriers in the way of receiving coverage for mental health care.

Family First Prevention Services Clearinghouse Posts New Ratings

The Family First Prevention Clearinghouse has posted new ratings for nine prevention services. Seven were found to be “promising,” and two were rated as “does not currently meet criteria.” The programs included mental health and in-home parent skill-based services. So far, 148 programs and services have been reviewed, and 76 have been rated as promising, supported, or well-supported. The new ratings are:

Proclamation Will Establish Monuments to Emmett Till and Mamie Till-Mobley

Last week, on what would have been Emmett Till’s 82nd birthday, President Joe Biden signed a proclamation to establish a monument honoring Till and his mother Mamie Till-Mobley. The racially motivated murder of 14-year-old Till and the subsequent activism of his mother played key roles in the civil rights movement.

The monument, the fourth national monument designated by the Biden administration, will span three sites in Illinois and Mississippi that hold historical importance. The first site will be in Graball Landing, Mississippi, where Till’s body was discovered in the Tallahatchie River. The second site will be Roberts Temple Church of God in Christ in Chicago’s Bronzeville neighborhood, where Till-Mobley held her son’s open-casket funeral. The monument’s third site will be the Tallahatchie County Second District Courthouse in Sumner, Mississippi, where an all-white jury acquitted Till’s killers.

In his remarks at the proclamation signing ceremony, Biden raised the importance of understanding our country’s history of racism as a means for moving toward social justice and rejected moves, such as those in Florida, to erase and twist it.

Biden noted, “At a time when there are those who seek to ban books, bury history, we’re making it clear — crystal, crystal clear — while darkness and denialism can hide much, they erase nothing. They can hide, but they erase nothing.”

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By: Dr. Daniel P. Hall Riggins and Verleaner Lane

According to the Center for Disease Control and Prevention, each year, there are nearly 3,500 sudden unexpected infant deaths (SUID) in the United States. In 2020, 27% of those deaths occurred in infants under the age of one due to an unsafe sleep environment.

The American Academy of Pediatrics understood the dangers of unsafe sleep nearly three decades ago, resulting in the launch of their Safe to Sleep, (formerly Back to Sleep) campaign in partnership with the National Institute of Child Health and Human Development. The campaign advocated for parents to place children on their backs to sleep and to remove loose bedding. As a result, child death rates from SUIDs dropped precipitously, but in the early 2000s those advances stalled, with infant mortality rates remaining stagnant at around 85-100 deaths per 100,000 births each year.

Since then, researchers have recognized that rates of infant death remain high in American Indian/Alaska Native and Black communities, leading child health experts to examine the role that race may play in these health disparities.

AAP updated its safe sleep guidance last year, with a focus on addressing disparities by contextualizing safe sleep behavior within broader societal and cultural factors, including the impact of poverty, lack of access to prenatal and well-childcare, and lack of culturally appropriate messaging around safe sleep. As a result, communities nationwide are taking a fresh look at sleep-related infant deaths through the lens of a population health approach.

That was one of the goals of Cook County Health Project CHILD’s participation in the Child Safety Forward initiative — one of five sites that was selected for a Department of Justice-funded grant to reduce child abuse and neglect fatalities and injuries through a collaborative, community-based approach.

An initial data review showed that Cook County’s SUID rate is twice the national rate and the Cook County incidence of SUID in Black infants was over 10 times higher compared to Non-Hispanic White infants, based on data from 2019.

Project CHILD began its efforts by using geospatial risk analysis mapping to demonstrate neighborhood “hot spots” of SUIDs. We discovered noted clusters of deaths on the Westside of Chicago in neighborhoods like Garfield Park, Humboldt Park, and North Lawndale; on the Southside in neighborhoods like Englewood, Pullman, and Woodlawn; and in Southern suburbs like Chicago Heights, Harvey, Hazel Crest, Olympia Fields, and Park Forest.

Project CHILD also approached the issue with an understanding that child welfare cannot do this work alone. In fact, data indicates that 50 percent of infants and children who die from fatal injuries caused by maltreatment, including unsafe sleep practices, are unknown to the child welfare system. This led to Project CHILD convening a multi-disciplinary group of stakeholders comprised of healthcare providers, community health workers, maternal infant health providers, educators, social service providers, and law enforcement – all those who come into contact with children and families.

We then partnered with the Child Protection Training Academy, (CPTA) located on the University of Illinois campus, which had created a simulation training model for DCFS Child Protection Investigators. The simulation was structured around training to recognize elements of unsafe sleep practices based on a fictional family with numerous underlying conditions including domestic violence, mental health concerns, substance use disorder and suspicions of sexual & physical abuse.

The simulation developed a home that was designed to draw attention to unsafe sleep practices, with the environment staged with a pack and play that was cluttered with clothing, bedding, and other objects. The simulation’s life-like doll was placed on a soft couch, to draw attention to other risk factors for unsafe sleep. Though the training was conducted on Zoom the teams were able to “investigate” the environment through the use of the “proxy” who walked through the home with a camera enabling the participants to see the home and its contents. Team members could ask for close up examination of particular items in order to determine what questions they might need to ask to gather additional evidence. Additional risk factors were added within the house, such as a premature infant and evidence of smoking.

What the simulation training revealed was that safe sleep issues were often not the primary concerns of members of the MDT as they observed the family’s home. Law enforcement, for example, is often called to homes for other reasons but are rarely trained to look for unsafe sleep practices.

It’s also important for members of the MDT to hear from families and parents with lived experience about the other factors that can influence sleep practices. Project CHILD met with families and heard from them about conflicting messaging coming from older generations who are respected for their wisdom, beliefs about the importance of skin-to-skin bonding, and, in communities where violence is prevalent, thoughts on family beds as perhaps one of the safer places for infants. We also heard loud and clear that families often do not trust public agencies and that the child safety messaging they do receive appears punitive and reactive.

Based on the insights from our geospatial mapping, simulation training and parent insights, we hope to create more advanced safe sleep trainings and guides for all stakeholders, not just those across the child welfare system. This information can also be used to assist in planning targeted messaging to hot spot communities, and the implementation of services and greater awareness, education and outreach to those communities.

Ultimately, we hope that, through the collaboration with key partners, such as Be Strong Families, EverThrive Illinois and the MDT teams, we can apply these learnings in new ways to enhance community understanding and action around safe sleep practices to reduce child fatalities.

Daniel P. Riggins, MD is a pediatrician with Cook County Health. Verleaner Lane is the project director for Project CHILD of Cook County Health, one of five Child Safety Forward sites.

Disclaimer: This product was supported by cooperative agreement number 2019-V3-GX-K005 Reducing Child Fatalities and Recurring Injuries Caused by Crime Victimization, awarded by the Office for Victims of Crime, Office of Justice Programs, U.S. Department of Justice. The opinions, findings, and conclusions or recommendations expressed in this product are those of the contributors and do not necessarily represent the official position or policies of the U.S. Department of Justice.

On July 17, the Streamlining Federal Grants Act of 2023 was introduced by Sens. Gary Peters (D-Mich.), James Lankford (R-Okla.), and John Cornyn (R-Texas). This bill would help enhance the efficiency and performance of federal grants and cooperative agreements. It proposes the establishment of a Grants Council composed of grantmaking federal agencies, which would guide reforming complex and outdated procedures.

Leaders from across the social sector shared statements of support for the bill in a press release from the U.S. Senate Committee on Homeland Security & Governmental Affairs. Among the quotes endorsing the bill was this one from Social Current President and CEO Jody Levison-Johnson:

“I am thrilled to see the introduction of the Streamlining Federal Grants Act of 2023 in the Senate, which reflects in part the Relief4Charities policy asks to strengthen and support the nonprofit sector. This legislation will greatly improve access to federal grants for underserved communities and streamline the application process.”

Social Current and the National Council of Nonprofits highlight the legislation’s provisions that benefit charitable nonprofits in this one-pager. Those provisions include:

VIEW ONE-PAGER

Social Current is monitoring the progress of the Streamlining Federal Grant Act of 2023 and will share updates in our Policy and Advocacy Radar newsletter. Subscribe online.

Social Current Leadership on Grant Reform

Social Current has been active in advocating for federal grant reform and educating our network about the issue. Earlier this summer, we hosted a policy briefing about the issue, which can be viewed on demand.

Blair Abelle-Kiser, senior director of government affairs at Social Current, discussed how we can set the nonprofit sector up for financial success through government contracting and grant reform. The conversation was inspired by the op-ed, “Government contract reform is a must for social sector nonprofits,” authored by Social Current President and CEO Jody Levison-Johnson in New York Nonprofit Media in February 2023. While there is still advocacy work to be done, this bipartisan bill is a significant step forward.

Upcoming Opportunity: Igniting Advocacy Training and Hill Day

SPARK 2023 will feature the Igniting Advocacy Training and Hill Day. Build foundational skills and learn about advanced advocacy strategies during the two-day training. Then, put what you’ve learned into action when meeting with members of Congress in Washington, D.C. We will take care of the logistics so you can focus on having meaningful interactions with key decision makers. Learn more about SPARK 2023, Oct. 16-17 in Bethesda, Maryland, and Hill Day, Oct. 18. Register by Sept. 18 to save with the early bird rate.