The Administration for Children and Families (ACF) released its inaugural data strategy to promote equity, enhance support for grant recipients, and invest in improved disaster preparation. ACF envisions 12 initiatives to responsibly exchange data across the human services landscapes. These initiatives are split among four categories to better inform policy and safely deliver services and benefits more quickly.
- Sustaining Initiatives will develop the foundational infrastructure to support the data strategy, including by creating a long-term funding and investment plan and establishing a data governance council.
- One Stop Shop Initiatives will create centralized resources to support program offices in building their data capacity, including by creating a data talent center to support hiring and team development.
- Delivery Initiatives will advance ACF’s use of data, including through centralized resources that support program offices in building their data capacity and by releasing community-centered data tools and stories.
- Technology Initiatives will provide the technology platforms and tools needed to streamline data reliability and enhance collaboration, including the launch of a customer relationship management system to coordinate across ACF.
Download a comprehensive overview of their data strategy to learn more about each of the initiatives and how they will support and strengthen data sharing throughout the sector.
Biden Administration Proposes New Rule to Increase Coverage of Contraception for Private Health Insurance Holders
The Departments of Health and Human Services, Labor, and Treasury recently released a proposed rule to significantly increase contraception coverage under the Affordable Care Act. The rule would enable women to obtain over the counter (OTC) contraception without a prescription at no additional cost such as emergency contraception and Opill, the first oral contraceptive approved by the Food and Drug Administration (FDA) for use without a prescription.
Additionally, the rule is expected to increase choice by mandating that plans and issuers expand the coverage of oral contraceptives and drug-led combination products, including intrauterine devices (IUDs). It reinforces plans and issuers’ responsibility to cover FDA-approved, cleared, and granted birth control methods at no cost to recipients.
The rule would require most private health plans to disclose OTC contraception is available without cost sharing or a prescription as well as to assist women in learning about their contraception coverage. Under the rule, plans and issuers would also be required to add a disclosure to the results of any online Transparency in Coverage self-service tool search for covered contraceptives explaining OTC contraceptives’ coverage.
Alongside the proposed rule, the Biden Administration issued guidance to ensure patients can access other preventative services, including cancer screenings, without cost. Comments may be submitted until Friday, Dec. 27.
IRS Releases Benefit Plan Notices
The IRS has issued guidance to expand the preventive care items and services High-Deductible Health Plans (HDHPs) may cover before plan deductibles are met.
Two notices released by the agency, which outline both expenses treated as paid medical care as well as preventive care for purposes of qualifying as a HDHP, include over-the-counter oral contraceptives, including OTC birth control pills, male condoms, and emergency contraceptives, regardless of whether they are purchased with a prescription. Non-mammogram breast cancer screenings, continuous glucose monitors, and selected insulin products were also named in the preventative care coverage.
Updates from the Judiciary
FTC Appeals Fifth Circuit Court’s Noncompete Ban
The Federal Trade Commission (FTC) requested the 5th U.S. Circuit Court of Appeals to review a Texas district court’s ruling which set aside the FTC’s ban on noncompete agreements in employment contracts. The Northern District of Texas issued its ruling in August, maintaining the FTC’s ban violated the Administrative Procedure Act by exceeding the commission’s statutory authority. The lower court argued that the Federal Trade Commission does not have the authority to create substantive rules regarding unfair methods of competition. The ruling stopped the Non-Compete Rule from nationwide enforcement.
The FTC’s non-compete rule would have prohibited employers from entering and enforcing new non-competes with all workers including, but not limited to: employees, independent contractors, externs, interns, volunteers, apprentices, and sole proprietors who provide a service to a client. It would require employers to notify current and former workers, excluding senior executives, that their non-competes are no longer enforceable. The rule would also render existing non-competes unenforceable, excluding senior executives.
A federal court in Florida similarly rejected the non-compete rule, but alternatively grounded their decision in the major questions doctrine. The major questions doctrine refers to the Supreme Court declaration that if an agency seeks to decide an issue of major national significance, its action must have clear congressional authorization. Considering the economic significance of non-competes, Florida’s federal judges ruled against their implementation. The FTC has since appealed its decision, although the rule remains paused.
A federal court in Pennsylvania upheld the rule, however, the company which brought the suit has since withdrawn the case. The judges rejected the company’s claims it would suffer irreparable harm to its contractual rights and investments in specialized training if the rule were to go into effect. The judges also affirmed the FTC acted within its authority to designate all non-compete clauses as unfair methods of competition.
As the FTC’s appeals are considered, employers can continue utilizing non-competes. The judges’ decisions, however, will likely have significant implications for the future of non-competes in employment contracts nationwide and will play a key role in defining the scope of the FTC’s regulatory authority.
Pharmaceutical Companies Appeal Medicare Drug Price Negotiation Program
AstraZeneca, Bristol Myers Squibb, and Janssen requested the Third Circuit Court of Appeals to revive their previously dismissed lawsuits challenging the government’s authority to negotiate Medicare drug prices.
Through the first round of negotiations, the prices of AstraZeneca’s diabetes medication, Farxiga, Bristol Myers’ blood thinner, Eliquis, and Janssen’s blood thinner, Xarelto, were each reduced between 56% and 68%. The negotiated prices will go into effect in 2026 and, projected, will save Medicare approximately six billion in the first year.
The pharmaceutical companies raised numerous concerns, such as the severe consequences of refusing to accept negotiated prices. Either by accepting steep penalties or withdrawing from Medicare, Bristol Myers Squibb argued the negotiation process amounts to an unconstitutional taking of property without just compensation.
Meanwhile, Janssen’s attorney grounded their argument in First Amendment concerns, maintaining that requiring companies to agree to a “maximum fair price” compels speech which violates their constitutional rights.
The pharmaceutical industry has filed eight lawsuits against the Biden Administration, challenging the validity of Medicare’s negotiation authority. Federal courts have continued to uphold the constitutionality of the drug price negotiation program, enforcing the importance of the Third Circuit’s ruling. A ruling in favor of Medicare would fortify the precedent needed to discourage future challenges. A ruling in favor of the pharmaceutical companies, however, is expected to impact access to life-saving medications significantly.
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The White House recently held a convening on child care to discuss state actions to improve the affordability of child care for working families, increase the number of child care providers, and improve child care workers’ job quality.
Lawmakers and organizations from 34 states across the country reflected on key strides, pathways for growth, and challenges faced within child care and early childhood education throughout the past year. State leaders discussed potential legislation to serve a greater number of working families, lower costs, and support providers. Key issues that were discussed included early childhood education teacher compensation and benefits, supply-building strategies, access and affordability of child care, and quality care assurance.
White House officials thanked state legislators for their leadership and expressed the Biden administration’s support for continued federal and state action to improve access to affordable, high-quality child care and support child care providers.
New Report on Maternal Health Care Access in Medicaid Managed Care
The U.S. Department of Health and Human Services’ Office of Inspector General (OIG) recently issued a report surrounding Medicaid managed care enrollees’ access to maternal health care. The review was conducted because of the country’s maternal health crisis, which is marked by significant racial and geographic disparities in maternal deaths and complications. The report emphasized the importance of Medicaid as the nation’s largest maternal health care payor.
States use provider coverage rules and network adequacy standards to ensure that Medicaid managed care enrollees retain adequate access to care. However, the OIG found states are not leveraging managed care provider coverage requirements and network adequacy standards to promote access to maternal health care services that can support improved maternal and infant health.
Specifically, many states do not cover mental health providers and professionals outside of OB-GYN physicians and hospital births, including midwives, maternal-fetal medicine specialists, doulas, and community health workers, some of whose services are federally required.
Other states were found to not utilize network adequacy standards, including time and distance requirements, which limit the distance enrollees should have to travel to visit their provider. Additional standards included appointment wait times to reduce how long patients wait for a visit and provider to enrollee ratio standards, which dictate the number of providers that networks must have in proportion to number of enrollees.
Vitally, some states lack data on how the standards impact enrollees’ access to maternal health care. The OIG accordingly recommends the Centers for Medicare & Medicaid Services (CMS) confirm all states cover required services from maternal health care providers for Medicaid managed care enrollees. They additionally recommend clarifying the requirement that States have a provider-specific OB-GYN network adequacy standard and supporting states in tailoring their network adequacy standards to better address maternal health care needs.
CMS agrees with each of OIG’s recommendations and is expected to respond with a plan of action within six months. CMS is planning outreach with states to ensure managed care enrollees have access to all required maternal health services. The agency will also assist states in adjusting network adequacy standards to meet the needs of residents in their states.
Final Guidance for Second Cycle of the Medicare Drug Price Negotiation Program
The Department of Health and Human Services recently released guidance outlining the process for the second cycle of negotiations under the Medicare Drug Price Negotiation Program.
The guidance centers how Centers for Medicare & Medicaid Services (CMS) will assist Medicare beneficiaries in accessing needed medications once negotiated prices become effective in 2026 and 2027, respectively. It discusses the requirements and parameters for how participating entities, including pharmacies and mail order services, will ensure designated Medicare Part D beneficiaries will have access to the negotiated prices.
The guidance also contains a key safeguard to ensure access to the maximum fair prices by allowing CMS to engage with a Medicare Transaction Facilitator to ease data sharing. Drug companies will also have access to the Facilitator for optional, voluntary payments between eligible individuals with Medicare and the pharmacies that serve them.
The next 15 medications covered by Part D for the second cycle of negotiations will be announced by February 1, 2025, while the negotiated prices will be effective beginning January 1, 2027. Fifteen patient-focused roundtables and one town hall meeting will also be held through spring 2025.
For additional information, CMS issued a fact sheet.
Additional Steps to Lower Prescription Drug Costs
HHS additionally released a request for information and a sample list of prescription drugs that the agency preliminarily intends to include under the proposed Medicare $2 Drug List Model, a key strategy within President Biden’s broader efforts to increase healthcare affordability and accessibility.
The Model provides a fixed copayment of no more than $2 for a month’s supply per drug for eligible Medicare Part D beneficiaries. The medications are intended to treat common conditions, such as high cholesterol and high blood pressure.
The Center for Medicare and Medicaid Innovation has released the plan with the intent of determining whether a simplified approach to offering low-cost, clinically important generic drugs can improve medication adherence, lead to better health outcomes, and improve satisfaction with the Part D prescription drug benefit among people with Medicare and prescribers.
Participation in the model is voluntary for Part D sponsors and, pending further development, is estimated to start as early as January 2027. Comments may be submitted until Dec. 9.
Updates from the Judiciary
Growing Concern of Social Media’s Impact on Adolescent Mental Health
Fourteen attorneys general, led by officials in New York and California, individually filed lawsuits against TikTok, claiming the social media platform damages young users’ mental health and collects the data of users younger than 13 without parental consent.
The bipartisan coalition alleged TikTok violates safety laws by claiming the platform is safe for youth, despite addictive features like 24/7 notifications and video autoplay. The filings also highlight dangerous TikTok challenges.
The legal coalition includes the attorneys general of California; Illinois; Kentucky; Louisiana; Massachusetts; Mississippi; New Jersey; New York; North Carolina; Oregon; South Carolina; Vermont; Washington; and Washington, D.C.
The lawsuit follows the passage of the Kids Online Safety Act (KOSA) through the House Energy and Commerce Committee and the Senate, which expressed overwhelming support as 91 Senators voted in favor. KOSA is intended to boost online privacy and safety for children, regulating the features offered and reducing the addictive nature of the platform. Nevertheless, bipartisan concerns have been raised of censorship and the suppression of free speech.
Federal Judge Removed from a Thirteen-Year Lawsuit Against Texas’ Child Protective Services
The Fifth Circuit Court of Appeals unanimously voted to remove Judge Janis Jack, a federal judge for the U.S. District Court for the Southern District of Texas. The Fifth Circuit detailed several instances in which Judge Jack was disrespectful and antagonistic toward Texas state employees and their lawyers. The Fifth Circuit judges maintained she inappropriately urged and instigated lawyers representing foster care children to provide evidence that Texas is willfully disregarding her orders for systemic improvements.
Judge Jack’s removal primarily follows the expansive reforms she mandated after determining Texas’ foster care system violated children’s constitutional rights. She levied heavy fines when state officials failed to meet compliance standards and found the state in contempt three times for failing to address unsafe conditions.
In April, Judge Jack issued a ruling that found Texas Department of Health and Human Services Commissioner Cecile E. Young, in contempt of her court orders to fix the way the state investigates complaints by children in its care. Her ruling carried a daily fine of $100,000 until the state could demonstrate an attempt to address its routine neglect of investigations into allegations of abuse and neglect of children in foster care.
The Fifth Circuit blocked that fine two days after Jack’s ruling and recently reversed it, maintaining it violates the court’s constitutional limits of power over individual states. The Fifth Circuit further affirmed federal judges do not have the power to become de facto superintendents, permanently overseeing major state agencies. Moreover, federal courts are not allowed to thwart the state’s self-management as they work to address identified abuses.
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The Office of Management and Budget (OMB) recently released guidance, effective Oct. 1, to reduce the barriers organizations face in accessing government grants. The revisions are intended to offer clarity and improve the readability of funding opportunities through plain, concise, consistent language. They are also expected to address longstanding challenges to recovering actual costs and reduce the burdens and costs of seeking, performing, and reporting on federal grants.
A few key provisions are highlighted below:
- Encourages community engagement
- Recommends considering diversity when developing merit review panels
- Permits language translations of programs and awards
- Allows federal agencies to offer pre-application technical assistance or provide clarifying information for funding opportunities
- Includes tribal organizations as an example of potentially eligible applicants
- Increased the single audit threshold to $1 million
Notice of Funding Opportunity: Funding details, an executive summary, and key dates will be required to be listed at the top of the notice before the announcement’s full text.
Reimbursement for Indirect Costs: Passthrough entities, often states and local governments and occasionally larger nonprofits, that use federal funds and all federal departments and agencies are required to reimburse a nonprofit for the reasonable indirect costs incurred performing services on behalf of governments.
15% Minimum Rate: Federal grants are now required to provide the guaranteed minimum (de minimis) rate for indirect costs of 15% of modified total direct costs. Federal agencies cannot compel recipients and subrecipients to use an indirect rate lower than the 15% de minimis rate unless required by statute. While organizations may choose not to utilize the 15% minimum, they cannot be forced to.
Mandated Application: Nonprofits are allowed to negotiate a higher rate through a negotiated indirect cost rate agreement (NICRA). Passthrough entities are then required to accept a grantee’s NICRA, although it remains subject to statutory and a few other limitations. Nonprofits with negotiated rates with one federal agency must be paid that same rate by all other federal, state, and local government agencies.
Right of Appeal: Receipts and subrecipients are now empowered to notify OMB of any disputes over how a federal agency applies or accepts their federally negotiated indirect cost rates or fails to pay the minimum indirect cost rate. For the first time, nonprofits can turn to OMB for help when federal agencies are not following the law.
Upfront Payments: Once financial and written procedures are met, the recipient or subrecipient of federal grants must be paid in advance. Meanwhile, reimbursable grants are preferred only when those requirements cannot be met. The guidance offers key flexibility as governments can be encouraged to make advance payments to nonprofits, rather than assuming that reimbursable grants are their only option or default.
Reporting Requirements: Federal agencies are instructed to eliminate reports that are not necessary to effectively monitor the grant. By encouraging agencies to only measure things that matter, nonprofits are able to redirect their efforts from burdensome, needlessly complex reporting requirements toward serving their communities.
Continuing Resolution Approved, Preventing a Government Shutdown
The U.S. House of Representatives and Senate negotiated a bipartisan continuing resolution to continue funding the government until Dec. 20. President Biden signed the bill shortly afterward. Congress has since adjourned and will return to session Nov. 12 to negotiate spending agreements on FY2025 spending bills funding key services, including housing and transportation.
A few of the programs and services that will continue to receive funding are included below:
- U.S. Federal Emergency Management Agency Disaster Relief Fund
- Supplemental Nutrition Assistance Program replacement benefits for victims of card skimming
- Temporary Assistance for Needy Families
- Special Supplemental Nutrition Program for Women, Infants, and Children
- Commodity Supplemental Food Program
- Tenant-Based Rental Assistance through the Department of Housing and Urban Development’s Public and Indian Housing Department
- Developmental Disabilities Surveillance and Research Program
- Autism Education, Early Detection, and Intervention
- Medicare Improvement Fund
- Extension of Funding for Health Care and Housing Programs That Serve Veterans
Executive Order to Address Emerging Firearms Threats and Improve School-Based Active-Shooter Drills
President Biden recently issued an executive order to address emerging firearms threats, including by preventing unauthorized access to firearms for youth and individuals in crisis. The order strives to address the mental health needs of students, particularly those impacted by gun violence. It also intends to support schools that are implementing evidence-based safety and gun violence prevention and intervention solutions.
The executive order additionally created an Interagency Emerging Firearms Threats Task Force to develop a risk assessment and strategy to stop the proliferation of machine gun conversion devices and address the emerging threat related to 3D printed firearms. Additionally, it directs key government agencies to develop and publish information about school-based active shooter drills for schools, including the appropriate frequency of such drills and the effects of such drills on students and educators.
Throughout, President Biden enforced the importance of an integrated approach to promoting the safety of students and educators, uniting the Department of Justice, the Department of Health and Human Services, the Department of Education, and the Department of Homeland Security.
House Ways and Means Committee Holds Hearing on Reforming Temporary Assistance for Needy Families
Chairman Jason Smith (R-Mo.) highlighted the House Ways and Means Committee’s efforts to promote stable, prosperous lives for families, including by reforming direct cash assistance. He stressed the importance of restoring integrity and accountability to Temporary Assistance for Needy Families (TANF) as he lamented waste, fraud, and abuse. Chairman Smith discussed the importance of guardrails to ensure funds are directed to those in need, including through data collection.
Ranking Member Richard Neal (D-Mass.) echoed the profound impact TANF funds can have on the well-being of families and the importance of ensuring families receive the assistance they deserve. He affirmed the importance of a multifaceted approach, including through an expanded Child Tax Credit, guaranteed child care, and paid family and medical leave.
Sam Adolphsen, policy director of the Foundation for Government Accountability, and Brett Favre, a former professional football player, spoke of the positive impacts of TANF through economic growth and falling rates of childhood poverty. They also discussed egregious instances of fraud, waste, and abuse associated with TANF funds and emphasized the importance of addressing loopholes that allow the misuse of funds. They recommended rebalancing program spending on work-related activities to combat fraud alongside increased accountability, oversight, and stronger guardrails.
Jarvis Dortch, executive director of the American Civil Liberties Union (ACLU) of Mississippi, echoed the presence of widespread abuse and fraud of TANF funds in Mississippi. He recommended policies that verify families in need are receiving assistance and stressed the importance of directing funds toward programs that meet the spirit of TANF, including quality child care and access to transportation. He warned of the harm of redundant verification systems while encouraging innovative programs to advance employment and assist low-income families. Dortch also urged the committee to pass legislation creating a TANF ombudsman program, which would be able to ensure compliance, monitor misspending, and gather data.
Representatives discussed potential reforms to ensure TANF-funded programs help those most in need while safeguarding against fraud and abuse. Representatives and witnesses also discussed the importance of work, underscoring the lack of requirements, incentives, and minimum standards for state spending on work, education, and training activities among TANF’s non-assistance funds. The hearing follows a report issued by the Government Accountability Office outlining preliminary observations on state budget decisions, single audit filings, and fraud risks within TANF.
Sector Updates from the Judiciary
Salary Tests Upheld for Overtime Pay
A Texas businessman recently challenged a rule issued by the Department of Labor in 2019. The rule raised the required minimum weekly salary to qualify for the exemptions for executives, administrators, and professionals (EAP) by more than 50%, from $455 to $684 per week.
On Sept. 11, 2024, the U.S. Court of Appeals for the Fifth Circuit ruled in favor of the U.S. Department of Labor. They affirmed the department’s authority to use a salary basis to define its white-collar overtime exemptions and to define the professions classified within the EAP exemptions.
The ruling establishes key precedent to defend the recently published April 2024 rule to further increase the minimum salary requirement for the EAP exemptions in similar legal challenges. Nevertheless, potential challenges to the 2024 rule remain, including from a Texas district court that has temporarily prevented the rule from taking effect for the state government’s employees.
The 2024 DOL rule raised the minimum weekly salary to qualify for the EAP exemption from $684 per week to $844 per week, or the equivalent salary of $43,888 per year, on July 1, 2024. Salaries are set to rise again on Jan. 1, 2025, when the minimum salary will increase to $1,128 per week, the equivalent of a $58,656 annual salary. Under the rule, the salary threshold would increase every three years based on up-to-date wage data.
For more information on the rule and employee classifications, view the Department of Labor’s fact sheet.
Student Loan Forgiveness Remains on Pause
Judge Hall, a judge for the District Court for the Southern District of Georgia, recently moved a challenge to President Biden’s student loan forgiveness plan from Georgia to Missouri. The challenge was brought by a coalition of seven Republican-led states, including Alabama, Arkansas, Florida, Georgia, Missouri, North Dakota, and Ohio.
Biden’s plan to ease student loan debt would erase up to $20,000 in interest for those who have seen their original balances increase. It would also provide relief to individuals who have been repaying their loans for 20 to 25 years.
Judge Hall ruled that Georgia failed to demonstrate it would experience harm following student loan relief. The Judge allowed the suit to be moved to Missouri, which stands to lose millions directly through the Missouri Higher Education Loan Authority, the nonprofit student loan servicer the state operates.
Judge Matthew Schelp, a district judge based in St. Louis, has since issued a preliminary injunction against President Biden’s student loan relief plan. Borrowers are not expected to witness any changes as student loan relief remains paused.
Texas Sues to Stop Biden Administration Rule Requiring Affirming Placements for Youth in Foster Care
Texas Attorney General Ken Paxton recently filed a lawsuit against the federal government claiming the requirement that states provide LGBTQ+ affirming placement for foster care youth would exacerbate the shortage of foster families.
The rule requires that child welfare agencies ensure that a foster parent is supportive of the child’s LGBTQI+ status, is knowledgeable and skilled to address the child’s needs, and is willing to provide access to appropriate resources to support the child’s well-being. Agencies are required to implement the rule by Oct. 1, 2026 as non-compliance jeopardizes Title IV-E and Title IV-B funding.
Paxton alleged the U.S. Department of Health and Human Services does not have the statutory authority to implement the rule and that it further violates the U.S. Constitution’s Spending Clause without fair notice. He additionally maintained the rule violates the Administrative Procedure Act as Title IV does not include any requirement for special accommodations for sexual orientation or gender identity.
Texas has asserted that the Texas Department of Family and Protective Services will implement the rule, but remains concerned of the potential harm to the state’s financial security and sovereignty. The suit asks the court to declare the rule unlawful, postpone its effective date, and grant a permanent injunction against its enforcement.
New Jersey Sues Hospitals Over ‘Discriminatory’ Pregnancy Drug Screens
New Jersey Attorney General Matthew J. Platkin and Director of the New Jersey Division on Civil Rights Sundeep Iyer filed a lawsuit against three Virtua hospitals in Southern New Jersey. The suit follows an investigation into complaints filed with the Division of Civil Rights by several pregnant women who gave birth at Virtua Voorhees Hospital. The patients were drug tested without informed consent after being admitted to the labor and delivery and high-risk obstetrics units.
The lawsuit claims the hospital’s mandatory drug testing policy violates the New Jersey Law Against Discrimination and the state’s right to privacy. Iyer underscored the potential trauma of the policy, as several families faced lengthy investigations for child abuse following screenings that incorrectly indicated drug use. Once the results were shared with New Jersey’s child welfare agencies, several individuals experienced unannounced home visits and some patients were not allowed to be discharged with their babies.
The lawsuit asks for an injunction to stop Virtua’s universal drug testing policy for pregnant patients and civil penalties against the South Jersey hospital system, including compensatory damages.
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On Sept. 9, President Joe Biden and Vice President Kamala Harris announced a rule that is expected to significantly advance parity for mental health care coverage. The protections will ensure mental health care coverage for 175 million Americans is on par with their physical health care coverage.
As President Biden stated, “Mental health care is health care. But for far too many Americans, critical care and treatments are out of reach. Today, my Administration is taking action to address our nation’s mental health crisis by ensuring mental health coverage will be covered at the same level as other health care for Americans. There is no reason that breaking your arm should be treated differently than having a mental health condition.”
The rule builds on the bipartisan Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA). MHPAEA fortified key protections to ensure group health plans and health insurance issuers that provide mental health or substance use disorder benefits do not enact less favorable benefit limitations compared to their medical/surgical benefits.
The rule requires health plans to evaluate their mental health care access, including assessing provider networks, payment rates for out-of-network providers, as well as using prior authorizations. It must then act accordingly to provide needed changes, potentially by expanding its network of mental health professionals or reducing bureaucratic hurdles. Health plans are also required to use similar factors in setting out-of-network payment rates for mental health and substance use disorder providers as they would for medical providers.
The above protections, and the inclusion of non-federal governmental health plans, are critical steps to increasing the accessibility and affordability of mental health care. For additional information, please see the U.S. Department of Labor’s general fact sheet as well as explanations for participants/beneficiaries, providers, and plans and issuers. The White House has also made a fact sheet available.
Addressing Food Distribution Shortages in Tribal Communities
On Sept. 11, the House Committee on Appropriations held a Joint Oversight Hearing titled “Severe Food Distribution Shortages in Tribal and Elderly Communities.” Representatives discussed the shortage crisis caused by the U.S. Department of Agriculture (USDA)’s consolidation of warehouses supporting the Food Distribution Program on Indian Reservations (FDPIR) and the Commodity Supplemental Food Program. The programs collectively serve approximately 800,000 individuals, ensuring dietary staples are received monthly.
Witnesses detailed how the consolidation, and resulting food shortages, jeopardized the welfare of their communities through extended delivery delays, missing items, and receipt of damaged and expired food. The USDA offered temporary solutions, but most were inaccessible to tribes. While temporary funding provides short-term relief, it does not address the inherent problems that stem from relying on a singular warehouse and distribution center.
Recommendations included a permanent expansion of the FDPIR pilot program, including by expanding the program to the Commodity Supplemental Food Program. The Honorable Darrell G. Seki Sr., chairman of the Red Lake Band of Chippewa Indians, additionally recommended moving to a regional sourcing model as well as establishing an automatic tracking system for deliveries.
USDA Secretary Tom Vilsack affirmed the USDA’s commitment to ensuring access to safe and nutritious foods as well as better partnering with tribal nations to empower tribal food sovereignty. Secretary Vilsack acknowledged past failures and discussed efforts to resume and improve programs immediately as well as in the short and long-term future. He further echoed the importance of consistent communication and outreach through consultations and feedback, especially in developing a more resilient, reliable distribution system capable of meeting their partners’ needs.
Committee members stressed the importance of accountability considering the harm tribal communities faced and the failure to fulfill responsibilities to tribes. They collectively expressed the unacceptability of inadequate access to nutrition and the need for corrective action.
The Inflation Reduction Act and Reduced Health Care Costs for Americans
Sen. Wyden (D-Ore.) detailed the key protections the Inflation Reduction Act (IRA) has offered in increasing the affordability of health care, including price gouging penalties, the out-of-pocket cap on prescriptions through Medicare Part D, and lower premiums through enhanced tax credits. He stressed the importance of further protecting and strengthening its terms.
Ranking Member Crapo (R-Idaho) spoke of the potential consequences of the IRA, including its impact on research and development, citing the 21 medicines and 36 research programs that have been discontinued since the law’s enactment. While he affirmed the importance of capping out-of-pocket costs for seniors’ prescriptions, he stressed hidden costs, warning how tax credits would grow the deficit. Crapo affirmed his commitment to bipartisan solutions that improve health care choice, affordability, and reliability.
Theo Merkel, Director of the Private Health Reform Initiative, also highlighted concerns about the financial implications of permanently extending the premium tax credit, estimating it would add $415 billion to ACA spending over a decade. He warned that enhanced coverage could lead to reduced employer-provided insurance and suggested improving risk adjustment and direct cost-sharing reduction payments for eligible enrollees.
Kirsten Axelsen, a Nonresident Fellow at the American Enterprise Institute, echoed these concerns, cautioning that reduced revenue could hinder investments in drug development for critical areas like rare diseases and senior medications. She advocated for greater transparency in drug selection for the Medicare Drug Negotiation Program, emphasizing the need for oversight of Medicare Part D formularies to ensure beneficiary access to affordable options.
Rena Conti, Ph.D., an Associate Professor at Boston University, highlighted that provisions in the Inflation Reduction Act (IRA), including negotiation, inflation rebates, and redesign of Medicare Part D, are actually projected by the Congressional Budget Office to save the federal government $58 billion by fiscal year 2031 without harming pharmaceutical innovation. She noted that the growth in sales of COVID-19 therapeutics and vaccines could further stimulate innovation, while also increasing coverage and profits for pharmaceutical companies.
Jeanne M. Lambrew, Ph.D., Director of Health Care Reform at the Century Foundation, supported Conti’s findings, citing nonpartisan research that demonstrates how the IRA’s health tax credit provisions enhance coverage and lower costs for consumers. Lambrew urged for the extension and expansion of the IRA, emphasizing the financial burdens Americans would face without healthcare coverage and the negative impact on healthcare providers.
Judy Aiken, a 70-year-old retired nurse, affirmed the challenge to afford the medication needed to manage chronic conditions she experiences. The costs significantly impacted her quality of life, straining her family’s budget until home repairs became unaffordable. Aiken shared the reduction in price and cap on out-of-pocket expenses signify she no longer needs to choose between her health and financial stability.
Committee members discussed the potential impact of the IRA on Medicare beneficiaries, emphasizing the need to end price gouging and increase access to care. They also expressed concern of the potential for premiums to rise while centralizing the experiences of their constituents.
Key Legislation Considered in the U.S. House of Representatives
House Committees held hearings to markup pending legislation. A few of the bills heard last week are discussed below.
U.S. House Committee on Ways and Means
- The Educational Choice for Children Act of 2024 provides taxpayers a tax credit for donations and charitable contributions to scholarship granting organizations. The scholarships are reserved for students in households with incomes at or below 300% of the median income level in their area. This bill passed the Committee with 23 Representatives voting in favor and 16 against.
- The Find and Protect Foster Youth Act requires the U.S. Department of Health and Human Services (HHS) to evaluate protocols utilized by states to determine the location of missing foster youth. The bill further requires HHS to provide states with technical assistance in determining children’s experiences while they are missing from foster care, including providing screenings for sex trafficking and determining appropriate services.
U.S. House Committee on Education and the Workforce
- The Jenna Quinn Law of 2024 amends the Child Abuse Prevention and Treatment Act to redirect grant funds toward training and educating school employees, students, and community members on preventing, recognizing, responding to, and reporting child sexual abuse among primary and secondary school students. All committee members voted in favor of this bill.
- Parental Rights Over the Education and Care of Their Kids Act, or the PROTECT Kids Act, requires any federally funded elementary or middle school to seek and acquire parental consent before changing their child’s pronouns, gender markers, or preferred name on any school form. The requirements also extend to allowing a child to change their sex-based accommodations, such as locker rooms or bathrooms. This bill was voted in favor by 22 Representatives, while 12 voted against.
- The Healthy Competition for Better Care Act bans anti-competitive terms in facility and insurance contracts that limit access to higher quality, lower cost care. The bill is estimated to save $3.2 billion in taxpayer dollars, according to the Congressional Budget Office. The committee voted in favor of advancing the bill.
- The Transparent Telehealth Bills Act of 2024 amends the Employee Retirement Income Security Act of 1974 to prohibit increased payments for telehealth services provided through hospital facilities. The bill unanimously passed the House Committee.
Energy and Commerce
- The Kids Online Safety Act establishes protections to prevent or mitigate harm from social media platforms, including through default safety settings and increased transparency for parents. The bill was approved by the Innovation, Data, and Commerce Subcommittee and will be sent to the Committee on Energy and Commerce.
- The Children and Teens’ Online Privacy Protection Act prohibits online companies from collecting personal information from users under 17 years of age without consent. It also bans targeted advertising to children and teens and establishes a Youth Marketing and Privacy Division at the Federal Trade Commission. The bill passed Committee with a strong majority of Representatives in favor.
- A joint resolution was introduced to prevent a federal rule that would establish minimum staffing standards for long-term care facilities and require transparency in reporting Medicaid institutional payments from being enforced. The resolution passed without amendment, with 21 Representatives voting in favor and 18 against
- The Telehealth Modernization Act of 2024 authorizes alternative sites of services and expanded practitioners to provide telehealth services under Medicare, as determined by the Centers for Medicare & Medicaid Services. The bill was unanimously voted in favor of by the Committee.
The U.S. House of Representatives also considered the Supporting America’s Children and Families Act, which reauthorizes and amends Part B of Title IV of the Social Security Act. The bill increases the availability of community-based resources for families, including through family resource centers. The bill further centers lived experience, family preservation, and continuous improvement. The legislation was passed by a voice vote, and all representatives who spoke were strongly in favor. The Senate has since read the bill and referred it to the Committee on Finance.
Sector Updates from the Judiciary
Revisiting the Denial of Benefits for Wilderness Therapy
The US District Court for the District of Utah recently returned a lawsuit regarding the coverage of wilderness therapy to a lower court for reevaluation. United Healthcare denied coverage for wilderness therapy because of its status as an unproven treatment. However, the Court maintained their denial of benefits was arbitrary because United Healthcare didn’t provide a sufficient explanation and analysis.
The decision upholds a key provision of the Employee Retirement Income Security Act, which requires United Healthcare to provide adequate notice with specific reasons for the denial in plain language for participants. By ruling in favor of the family, the court fortified precedent mandating insurance companies include explanations of the scientific or clinical judgment used to deny the benefits.
Extended Statute of Limitations
A home health care company’s lawsuit was previously dismissed because it was filed after the six-year statute of limitations set by the Administrative Procedure Act (APA). It was reinstated, however, after the Supreme Court issued a landmark ruling in Corner Post, Inc. v. Board of Governors of the Federal Reserve System. The verdict maintains the statute of limitations does not begin until an organization is harmed by a final agency action. One of the judges dissented in part, arguing the statute limitations do not begin until the business is created.
The health care company’s lawsuit surrounds a regulation issued by the Department of Labor in 2013, which clarifies which home care workers meet the law’s minimum wage and overtime pay requirements under the Fair Labor Standards Act. Previously, the lawsuit was dismissed as the court agreed with the Department of Labor that the six-year statute of limitations began when the final rule was issued in 2013.
By returning the lawsuit to a lower court, the 3rd U.S. Circuit Court of Appeals demonstrated a key potential of Corner Post to allow organizations to challenge harmful regulations beyond the APA’s statute of limitations for civil actions.
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When the Commission to Eliminate Child Abuse and Neglect Fatalities released its groundbreaking report in 2016, much of the focus was on identifying risk factors. Since that time, however, through national initiatives such as Child Safety Forward and the response to the COVID-19 pandemic, we’ve learned that a preventive, public health approach requires an emphasis on protective factors and family strengthening policies.
With these strategies in mind, the Within Our Reach team at Social Current has developed a new Policy, Education, and Communications Toolkit that offers the latest research, resources, learnings, and tools for building a 21st-Century Child and Family Well-Being System that is based on identifying protective factors and strengthening families.
Download the toolkit for:
- The latest insight on family strengthening policies
- How to use framing science to effectively communicate about child welfare
- Recommendations for parents, stakeholders, and child protective services agencies
- Tips for advocacy efforts
- Tips, tools, and templates for engaging media
This toolkit was created with support from Casey Family Programs and with input from a Parent Steering Committee including parents with lived experience. We invite you to share this with your constituencies and to utilize it in support of messaging and policies that will help a broad range of stakeholders continue to strengthen families through a public health response to child and family well-being.
Please download the toolkit online.
On Aug. 28, U.S. Surgeon General Dr. Vivek Murthy, released an advisory highlighting the immense stress caregivers report and the urgent need to better support parents, caregivers, and families to help our communities thrive. The report follows new and emerging challenges, including the complexity of managing social media, the youth mental health crisis, and an epidemic of loneliness that disproportionately affects young people and parents.
The surgeon general’s advisory details the relationship between parental stress and mental health, its impact, and pathways for action. Murthy recommended expanding community programs to ensure affordable child care, reliable mental health care, paid time off, spaces for social connection to build community, and encouraging communities to speak openly about the challenges parents face. He further spoke of a value shift to truly recognize the extraordinary impact of caregivers and collectively envision raising children as a shared responsibility through our policy, programs, and behavior.
The advisory highlights heightened stressors parents and caregivers face, including financial strain and economic instability, time demands, concerns over children’s health and safety, isolation and loneliness, difficulty managing technology and social media, and cultural pressures. The American Psychological Association reported that 41% of parents say that most days they are so stressed they cannot function, while 48% say that most days their stress is completely overwhelming compared to other adults.
Chronic and excessive stress experienced by parents and caregivers can adversely affect their mental and physical health, especially when considering the multiple sources of stress. Parental stress is often experienced by children, as parental mental health can influence the emotional climate, responsiveness, and consistency of caregiving, all of which are essential for a child’s emotional and cognitive development and long-term health.
The advisory stresses the importance of addressing parental mental health conditions and the underlying stressors and causes to decrease exposure to chronic or severe parental stress, empower parents to meet both their needs and the needs of their children, and reduce the likelihood of mental health conditions. The recommendations spanned community-wide from governments to employers, community organizations, health and social service systems and professionals, researchers, and families.
Biden Administration Announces Funding Awards to Advance the President’s Unity Agenda
The Biden administration recently directed significant funding toward integrating primary and behavioral health care, supporting mental health care, expanding substance use disorder treatment, and enhancing maternal mortality research and prevention efforts. The grants and funding opportunities reflect key pillars of President Biden’s Unity Agenda, including increasing the affordability and accessibility of mental health care.
Grants for Navigators to Increase Access to Health Care
The administration announced $100 million in awards to navigators to assist millions of Americans in registering for health care coverage through HealthCare.gov. The grants are awarded through the Centers for Medicare & Medicaid Services and directed toward 44 Navigator grantees in states utilizing HealthCare.gov. The grants will be offered with extended grant periods and in advance of Marketplace Open Enrollment, which will begin Nov. 1. They will be directed toward organizations working with underserved communities, consumers, and small businesses.
Funding to Integrate Primary and Behavioral Health Care and Expand Drug Treatment Court Capacity
The Substance Abuse and Mental Health Services Administration (SAMHSA) announced $81.3 million in grant awards. Approximately $16 million is directed to support the integration of primary and behavioral health care, while $24 million will expand the capacity of drug treatment courts. Additional awards will support tribal behavioral health, advance prevention science, support communities of recovery, and increase access to care through the screening, brief intervention, and referral to treatment public health model.
Prevention, Treatment, and Workforce Enhancement Awards
An additional $65.7 million in grant awards and notices of funding opportunities were announced through the Strategic Prevention Framework – Partnerships for Success program. The funds are intended to assist tribes, state and local governments, colleges, and universities in developing and delivering substance use prevention services. Additional awards will support youth with unmet behavioral health needs and increase access to behavioral health care for people who are or are at risk of becoming unhoused. The grants further aim to enhance the behavioral health workforce by supporting substance use disorder (SUD) training for graduate-level healthcare professionals.
Funding to Support Maternal Health and Home Visiting Programs
The U.S. Department of Health and Human Services announced more than $558 million in funding to improve maternal health. The vast majority, $440 million, will be directed to expand voluntary, evidence-based maternal, infant, and early childhood home visiting services. Additionally, the Centers for Disease Control and Prevention (CDC) will utilize $118.5 million across five years to expand Maternal Mortality Review Committees (MMRCs) from 46 to 52 states and U.S. territories and freely associated states.
Sector Updates from the Judiciary
Growing Challenges to Accessing Health Care for Transgender Adolescents
The 11th U.S. Court of Appeals recently upheld an Alabama bill restricting access to gender-affirming care when it declined a request to reconsider bill. Among the bill’s comprehensive provisions, it designates the prescription of puberty blockers or hormones to aid in the gender transition of individuals younger than 19 as a felony, punishable by up to 10 years in prison.
Four judges dissented, stressing the harm of restricting parents’ fundamental right to obtain medical treatment for their children. They further expressed concern for future access to broader medical care, especially if families have restricted pathways to bring legal challenges as with the 11th Circuit.
Alabama stands as one of 26 states that have adopted laws restricting or banning gender-affirming medical care for transgender youth. The U.S. Supreme Court and the 6th U.S. Circuit Court of Appeals have allowed Idaho, Kentucky, and Tennessee to enforce their bans as litigation continues. Nevertheless, a definitive ruling is largely dependent upon the Supreme Court, which has agreed to hear a lawsuit questioning the constitutionality of restricting gender-affirming care following challenges to a Tennessee bill. The legislation restricts the use of state funds for gender-affirming care and prohibits gender-affirming surgical care for minors.
Meanwhile, 16 states and the District of Columbia, have adopted shield laws to safeguard access to gender-affirming care, including by preventing providers and patients from facing civil or criminal charges from another state where care is prohibited.
Alongside the Supreme Court decision, elections are likely to significantly impact adolescents’ access to gender-affirming care. A critical example is Arizona’s election of Gov. Katie Hobbs, who issued an executive order guaranteeing insurance coverage for surgeries among state employees and protecting individuals from investigations initiated by other states. The order was issued one year after Arizona’s legislature banned gender-affirming surgeries for minors.
Mental Health Care Order Within California Prisons
The Ninth Circuit recently upheld a lower court’s ruling, affirming the right of inmates experiencing mental illness in California to have access to a minimum of 20 hours of mental health treatment per week for in-patient programs. California argued that the order did not comply with the Prison Litigation Reform Act of 1995, which requires the relief to go no further than is needed and be as non-intrusive as possible. The state also maintained that U.S. District Court Chief Judge Kimberly Mueller lacked evidence to support a 20-hour minimum.
A previous recommendation declined to set a minimum number of hours for treatment, alternatively requiring clinical assessment and treatment teams to determine all treatment decisions. Nevertheless, Judge Mueller rejected the absence of a minimum time requirement, establishing a key protection through a baseline level of care. The 20-hour minimum additionally reflects the minimum treatment levels mandated by the Department of State Hospitals, California’s state hospital system.
The decision is a key step to safeguarding the right of incarcerated individuals to access mental health care. Nevertheless, the order arrives during severe shortages of mental health professionals and despite Gov. Gavin Newsom’s longstanding efforts to expand care and recruit and retain mental health professionals.
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Voter engagement efforts build stronger community-based organizations. When residents vote, organizations have greater access to elected officials, increased clout on issues, and are better positioned to advance their mission.
In addition, engaging communities on issues that directly impact them helps make programs and services more effective and candidates are more likely to hear and respond to concerns.
Each organization, with its own unique mission, can integrate voter engagement in similar ways. Social Current has collaborated with Nonprofit VOTE to offer a new toolkit to assist in voter engagement: Strategies for Mobilizing Voters: A Toolkit for Community-Based Organizations.
The toolkit includes:
- Information on staying nonpartisan
- Strategies for engaging staff and community members
- Voter registration and pledge card scripts
- Success stories from community-based organizations
Network Spotlight: Wellpoint Care Network
Wellpoint Care Network in Milwaukee demonstrates how voter engagement has the power to ensure the organization’s mission remains relevant during and after elections.
Starting in early in 2020, Wellpoint Care Network committed to targeted voter outreach. Staff team leads spearheaded voter registration events as well as informational tables for voter education. They also disseminated materials like toolkits with voting information.
Ann Leinfelder Grove, president and CEO of Wellpoint Care, said: “We worked to promote the understanding that in a democracy, your vote is precious.”
The organization also used these public-facing opportunities to focus on foster parent recruitment and building a network of community partner organizations to address the social determinants of health. They found unique and effective ways to integrate voter engagement efforts with their mission.
Additional Resources
Join Social Current on Dec. 4 for a free webinar, Strengthening Community Impact Through Advocacy, to gain a comprehensive understanding of building policy literacy, crafting compelling narratives, engaging in coalition building, and developing disciplined messaging strategies.
Nonprofit VOTE also offers a resource library and several on-demand webinars:
- Rally the Sector: Nonprofits and Election 2024
- Staying Nonpartisan for 501c3 Nonprofit Organizations (English Version)
- Staying Nonpartisan for 501c3 Nonprofit Organizations (Spanish Version)
- Getting a Head Start: Planning Your Voter Outreach for 2024
- Talking with Voters
Contact Abigail Levine, field mobilization and policy manager, for more information.
The U.S. Department of Health and Human Services (HHS), through the Administration for Children and Families (ACF), has introduced a significant new rule to strengthen the Head Start program by increasing staff wages and benefits. The rule, titled Supporting the Head Start Workforce and Consistent Quality Programming, will raise annual wages for most Head Start teachers by approximately $10,000, improving the program’s ability to recruit and retain qualified educators and ensuring consistent, high-quality early childhood education.
For nearly six decades, Head Start has provided essential early childhood education to children who are often furthest from opportunity. This new rule builds on the Biden-Harris Administration’s commitment to expanding and enhancing early childhood programs and sets the stage for further collaboration with Congress to secure sustained investments in Head Start.
HHS Secretary Xavier Becerra emphasized the importance of this rule, stating, “For too long, Head Start has relied on staff who are often paid poverty-level wages. This rule changes that, ensuring our most vulnerable children have access to essential educational opportunities.”
ACF officials highlighted that the rule addresses the staffing shortages which have plagued many Head Start programs by increasing wages, reducing turnover, and elevating service quality. ACF Deputy Assistant Secretary for Early Childhood Development, Katie Hamm, noted, “This rule is a critical step toward reversing the trend of classroom closures and putting Head Start on a sustainable path.”
Khari Garvin, Director of the ACF Office of Head Start, added that the rule incorporates feedback from the Head Start community, offering greater flexibility and tailored implementation for smaller programs while reducing administrative burdens.
Head Start programs operate in every state, numerous Tribal nations, and U.S. territories, delivering comprehensive services in early learning, health, and family well-being. Serving children from birth to age five, the program tailors services to local needs, ensuring children across the country receive the support and education they need to thrive.
Medicare Drug Price Negotiation Program
On Thursday, Aug. 15, the Centers for Medicare & Medicaid Services (CMS) announced the negotiated prices for the first ten prescription drugs, a key provision of the Inflation Reduction Act.
The adjusted prices will become effective for individuals enrolled in Medicare with Part D prescription drug coverage on Jan. 1, 2026.
The negotiated prices are expected to increase access to some of the most expensive and most frequently dispensed drugs by reducing the prices between 38% and 79%. The medications treat critical conditions, including diabetes, heart failure, arthritis, and more. They had been prescribed to nine million patients with Medicare coverage in 2023, who paid $3.4 billion in out-of-pocket costs the previous year for these medications. The reduced prices are expected to alleviate a critical barrier, increasing affordability and access.
Individuals enrolled in Medicare with Part D prescription drug coverage are expected to save $1.5 billion in out-of-pocket costs. Meanwhile, the CMS reported a $6 billion reduction in spending following the negotiated prices.According to the Congressional Budget Office, if the policy continues to move forward as planned, the drug price negotiations are expected to save the U.S. government about $98.5 billion by 2031.
The Inflation Reduction Act includes vital provisions to generate further cost savings for Medicare beneficiaries. Annual out-of-pocket expenses will be capped at $2,000 in 2025, rebates will be provided if certain drug price increases outpace inflation, and out-of-pocket costs for vaccines will be eliminated.
Negotiations are expected to continue for up to 20 drugs covered under Part D or Part B every year through 2026. The U.S. Department of Health and Human Services Secretary Xavier Becerra stressed the importance by stating, “Empowering Medicare to negotiate prices not only strengthens the program for generations to come, but also puts a check on skyrocketing drug prices.”
While several lawsuits have claimed the negotiations exceed the federal government’s authority and violate pharmaceutical companies’ constitutional rights, all lawsuits have been denied to date. Social Current will monitor the appeals process and provide updates accordingly.
Sector Updates from the Judiciary
Florida Appeals Court’s Release of Investigative Report in Moeller v. Southeast Florida Behavioral Health Network
On Aug. 15, a Florida state appeals court overturned a lower court’s decision, which blocked the release of an investigative report concerning the completed suicide of an individual shortly following discharge from a mental health center.
Initial record requests were filed according to the Florida Public Records Act (FPRA) and denied due to the unproven claim the report was protected under an FPRA exemption for the medical review committee.
In providing the records to the individual’s family, the state appeals court affirmed their legal right to the report while upholding the family’s due process rights.
Catholic Charities Appeals to U.S. Supreme Court for Religious Exemption
On Aug. 9, Catholic Charities of the Diocese of Superior Wisconsin appealed to the U.S. Supreme Court to reverse a previous decision issued by the Wisconsin Supreme Court. The ruling required the agency to participate in the state’s unemployment system, claiming they do not qualify for a religious exemption because their activities are not “primarily” religious.
Wisconsin law requires all employers to pay an unemployment insurance premium on behalf of their employees, granting their employees access to weekly unemployment benefits if they lose their jobs. Members of a religious order, employees of churches or their parent associations, and those who work for organizations operated primarily for religious purposes and are controlled by churches or church associations have historically been considered exempt from this law.
The Catholic Charities Bureau sought an exemption to participate in an alternate program, the Church Unemployment Pay Program, established by the Wisconsin bishops in 1986. The agency claimed the program provides equal benefits with greater efficiency, allowing them to direct their cost savings to further their mission and grow charitable efforts.
Nevertheless, the Wisconsin Supreme Court ruled the Catholic Charities Bureau does not meet the standard of operating primarily for religious purposes. The Court reasoned that the services can similarly be provided by organizations without a religious purpose, especially considering the agency hires and serves all individuals, regardless of religious affiliation.
The Catholic Charities Bureau claims the Wisconsin Supreme Court’s ruling impacts their First Amendment rights by penalizing their agency for engaging in parts of its ministry, including serving those in need without attempting to proselytize. Should the United States Supreme Court accept the case, their verdict would likely impact religious organizations’ ability to receive religious exemptions nationwide.
Subscribe to the Policy and Advocacy Radar to receive our biweekly policy roundup, which includes commentary on issues in Social Current’s federal policy agenda, opportunities to take action, and curated news and opportunities.
“There’s always an opportunity to become a better advocate,” said Jonathan Vasquez, government relations and advocacy assistant at Children’s Institute in Los Angeles. “That’s what the families and communities we serve at the Children’s Institute deserve—people who have the expertise and knowledge to be effective champions of the work.”
Using a whole-family approach, Children’s Institute helps children and families discover strengths and develop skills that create enduring success. For over 20 years, its Project Fatherhood program has provided parenting support to 15,000 men in caregiver roles in Los Angeles.
“After hearing directly from those we serve how often they felt disregarded, forgotten, and disposable, there was a desire to center the emotional and behavioral well-being of fathers in our work,” said Vasquez. “Centering community and lived experience in policy solutions ensures the dreams and aspirations of the communities we serve are reflected.”
After hearing the input of fathers and participating in several advocacy trainings hosted by Social Current, Children’s Institute recognized a need to advocate within all levels of government to bolster and expand this work.
Engaging over 100 fathers, community partners, and government agencies, Children’s Institute held a series of listening sessions that allowed LA County representatives to hear directly from fathers impacted by systemic inequity. These sessions resulted in 27 recommendations advanced by the county in areas including child services, mental health, economic support, and the justice system.
Children’s Institute’s Government Relations & Advocacy and Project Fatherhood teams cultivated a network of elected officials to champion father well-being and amplify a new narrative about fathers. The effort declared June “Fatherhood Well-Being Month” each year in the state of California through House Resolution 36.
With several federally funded initiatives—including Project Fatherhood—Children’s Institute seeks to expand its advocacy efforts at the federal level. Recently, the Government Relations & Advocacy team attended Social Current’s 2024 Advocacy Amplified Training and Hill Day, where they were able to advocate for Head Start funding to further propel their programs forward. Social Current staff also reviewed and provided feedback on their public policy and advocacy agenda to ensure greater impact.
“We are so thankful for our partnership with Social Current,” said Terry Kim, director of government relations and advocacy at Children’s Institute. “They facilitate opportunities to connect with organizations across the country, enhancing our impact and supporting our growth to be stronger advocates for our communities.”
Social Current offers customizable solutions to help organizations expand their advocacy efforts and increase their impact–from advocacy and government relations advising, strategy development, and more.
To learn more about Children’s Institute’s father engagement and government relations work, participate in Children’s Institute’s workshop at SPARK 2024. Registration is now open for SPARK 20204, to be held Oct. 21-22 in Denver.
The National Council of State Legislatures recently issued a report examining critical child care and early childhood legislative and regulatory proposals, potential for bipartisan agreement, and implications for states. The report follows critical appropriations, including $52.5 billion for the Child Care and Development Fund and $2 billion for Head Start. The additional funding, however, is temporary and federal legislation has yet to be passed to permanently address the cost and accessibility of child care.
The reforms are especially important to consider alongside rising costs of child care and limited availability of slots that have prevented countless families from accessing formal child care arrangements.
Build Back Better
Senate negotiations of the Build Back Better Act prevented the inclusion of early childhood provisions. Nevertheless, they reflect the Biden administration and several Democratic Congress members’ early childhood policy goals. The core components may also be seen in the Child Care for Working Families Act, which has been introduced in the 117th and 118th Congresses with strong Democratic support.
The administration mirrored the Child Care and Development Fund (CCDF) model by expanding eligibility for child care subsidies and capping the cost to families according to income level. The proposal also includes a cost estimation model to set payment rates to achieve pay parity between similarly experienced and credentialed child care and elementary educators.
The Biden administration’s Build Back Better proposal would have also implemented universal preschool available to all families, regardless of income and employment status. State participation is voluntary, and those that opt out would receive federal grants directly available to localities and Head Start providers.
Child Care and Development Block Grant Reauthorization Proposal
Senators Tim Scott (R-S.C.) and Richard Burr (R-N.C.) introduced a bill to reauthorize the Child Care and Development Block Grant (CCDBG) Act, which was last reauthorized in 2014. S. 3899 expands eligibility to low-income families, including by reducing co-payments. The bill also establishes cost estimation models to set provider payment rates.
Child Care for Working Families Act
The Child Care for Working Families Act was first introduced in 2017 and served as the foundation for the Biden administration’s Build Back Better child care and preschool provisions. Rep. Bobby Scott (D-Va.) and Sen. Patty Murray (D-Wash.) reintroduced the bill, H.R. 2976 and S.B. 1354, in 2023. It gained significant support as the leading Democratic proposal on early childhood education.
The Child Care for Working Families Act establishes federal-state partnerships to expand eligibility for child care subsidies and reduce co-payments for low-income families. Additional grants would be directed to open new child care facilities, growing choice between providers for families. For states that decline grants, funds become available to localities.
The Act creates early education formula grants to increase wages and benefits for child care staff, promote financial stability among providers, reduce burnout and fatigue, and encourage high-quality care. Similar to the Biden Administration’s Build Back Better provisions, preschool would become available to all families regardless of income and employment status. Head Start services would also become available through full-day, full-year programs.
Recent Rulemaking
CCDF Final Rule
In February 2024, the Department of Health and Human Services (HHS) released a new final rule issuing key amendments to the Child Care Development Fund (CCDF). States are now required to pay providers according to enrollment at the beginning of the month, rather than attendance at the end of the month. Additionally, HHS has capped family co-payments at 7% of their income. While not required, states are encouraged to waive copayments for families with a minimum income reaching 150% poverty line and presumptively consider the possibility of CCDF-eligible children as well.
The rule does not offer additional federal funding, leading states to absorb costs. However, states may request waivers of up to two years for certain required provisions.
Head Start Proposed Rule
In November 2023, the Department of Health and Human Services (HHS) released a proposed rule significantly amending Head Start Performance Standards.
The rule would increase staff wages, benefits, and wellness with the goal of achieving pay parity between Head Start staff and local K-3 teachers. It would also require programs to have a multidisciplinary mental health team, mental health consultations at least monthly, and integrated mental health support services for families.
The rule further encourages identifying and meeting community needs, including by creating a maximum caseload of 40 families per family service worker. Similarly, families’ gross income will be adjusted to account for elevated housing costs.
Nevertheless, like the CCDF Final Rule, the Head Start Rule is not authorized to provide additional federal funding. The rule’s provisions accordingly hold varying implementation timelines, ranging from 60 days to 7 years. Staff wages are not expected to go into effect until Aug. 2031, while the final rule is expected to be released by the end of 2024.
Areas of Potential Bipartisan Support
Tax Credits
Tax credits have gained significant support, including from the co-chairs of the Bipartisan Pre-K and Child Care Caucus. Two notable bipartisan bills have also been introduced: Tax Relief for American Families and Workers Act (H.R. 7024) and Child Care Investment Act (H.R. 4571).
- The Tax Relief for American Families and Workers Act was led by Sen. Ron Wyden (D-Ore.) and Rep. Jason Smith (R-Mo.). The bill sought to enhance the Child Tax Credit (CTC) for low-income families by allowing the use of prior year earnings for calculation. It would also increase the maximum credit amount per child over the course of three years and tie additional per-child increases to inflation.
- The Child Care Investment Act was sponsored by Rep. Salud Carbajal (D-Calif.) and Rep. Lori Chavez-DeRemer (R-Ore.) and endorsed by the bipartisan Problem Solvers Caucus. The bill proposed making the Child and Dependent Care Tax Credit (CDCTC) fully refundable, raising credit rates, expanding the 45F credit for employer-provided child care, and enhancing Dependent Care Flexible Spending Accounts (FSAs).
Improving Child Care Infrastructure
Bipartisan support additionally exists to support the establishment and maintenance of child care facilities, which would in turn address shortages and increase choice for families. The Biden administration’s Build Back Better proposal and Republican Child Care and Development Block Grant reauthorization proposal enabled states to direct a portion of funds toward facility-related needs. Additionally, a current draft of the Farm Bill encourages directing grants from the Department of Agriculture toward child care facilities in rural areas.
Recent Reauthorizations to Support Vulnerable Populations
Older Americans Act Reauthorization Act
Chairman Sanders and Ranking Member Cassidy opened the U.S. Senate Committee on Health, Education, Labor, and Pensions by thanking the bills’ authors and staff before discussing S. 4776, the Older Americans Act Reauthorization Act of 2024. The bill has gained bipartisan support within Congress as well as from organizations like Meals on Wheels and AARP.
Senator Sanders highlighted the Older Americans Act’s importance in reducing the poverty rate among seniors while increasing access to assistive technology, nutrition, health care, and wellness. Its reauthorization would increase the act’s funding from its current amount of 2.3 billion to 2.76 billion in fiscal year 2025 and eventually to 3.3 billion in 2029.
Additional funding will enable millions of seniors who are currently on waitlists to access meals and housing. It will also increase access to health screenings, strengthen senior centers, support home health care workers, and address the mental health needs many elderly individuals are experiencing. Additionally, the reauthorization will support the Long-Term Care Ombudsman Program, a critical safeguard to protect the health, safety, welfare, and rights of long-term care residents. Funding will further be directed toward the Advisory Council to Support Grandparents Raising Grandchildren.
Several members of the U.S. Senate Committee spoke favorably of the reauthorization before voting in favor of the Act, demonstrating strong bipartisan support through a vote of 20 to 1.
Autism Collaboration, Accountability, Research, Education, and Support Act of 2024
Sen. Lujan (D – N.M.) commended the advocacy of parents and loved ones in developing the legacy of the Autism CARES Act, which has provided funding for research, training for providers, and the development of diagnostic tools and evidence-based interventions.
Through increased awareness and public health programs offering support for children with autism and other developmental disabilities, children have begun to receive earlier diagnoses and interventions. The Autism Cares Act increases access to both immediate and long-term services and support by addressing behavioral health and communication needs through their lifespan.
Sen. Collins (R-Maine), who cosponsored the reauthorization with Sen. Lujan, amplified the need for additional research and programming. She spoke of the impact Leadership Education in Neurodevelopmental and Related Disabilities Programs, or LEND, have had in Maine and encouraged Senate colleagues to extend additional support for the programs.
The Autism Collaboration, Accountability, Research, Education, and Support Act of 2024 was reauthorized with strong bipartisan support through a vote of 20 to 1.
Traumatic Brain Injury Program Reauthorization Act of 2024
The Traumatic Brain Injury Program Reauthorization Act of 2024 identifies and addresses gaps in data of traumatic brain injuries, highlighting populations with a higher risk. It also reauthorizes Administration for Community Living grants to states for traumatic brain injury rehabilitation and other supportive services.
Sen. Mullins (R-Okla.), who introduced the Traumatic Brain Injury Program Reauthorization Act of 2024, emphasized the need for ongoing research and spoke of the hope the bill offers. He expressed gratitude to the committee for their bipartisan support.
The strong support for the bill was reflected in the committee’s vote as its reauthorization was approved by a 20 to 1 vote.
Sector Updates from the Judiciary
Corner Post, Inc. v. Board of Governors of the Federal Reserve System
On July 1, 2024, The United States Supreme Court issued a decision that significantly expands the amount of time available to challenge the actions of a federal agency.
Previously, lawsuits against federal regulators were required to be filed within six years from the date the agency rule went into effect according to the Administrative Procedure Act (APA). However, the Supreme Court’s ruling amended the time plaintiffs are allowed to challenge regulations according to the date of injury. The statute of limitations accordingly extends from the initial time of harm through the next six years, regardless of the date of publication.
The challenge was brought by Corner Post, a truck stop in North Dakota, who disputed the regulation the Federal Reserve issued to govern the fees merchants are obligated to pay banks when customers use a debit card. Although the regulation took effect in 2011, the truck stop did not open until 2018 and filed the suit in 2021.
Similar to the ruling of Loper Bright v. Raimundo, which empowered courts to interpret unclear agency regulations, the Supreme Court’s decision will likely invite additional lawsuits. Corner Post extends recently formed entities to the ability to challenge regulations that have stood for decades. The decision holds the power to impact countless government regulations, ranging from workplace safety to health care. Justices Jackson, Kagan, and Sotomayor referenced the far-reaching implications through a previous suit challenging the Food and Drug Administration’s (FDA) approval of mifepristone, one of two drugs prescribed for medical abortions. The case was previously dismissed because of the statute of limitations, although the verdict may allow recently formed entities to challenge the FDA’s approval.
Justice Ketanji Brown Jackson expressed deep concern in her dissent, joined by Justices Sotomayor and Kagan. The Justices warned, “The tsunami of lawsuits against agencies that the Court’s holdings in this case and Loper Bright have authorized has the potential to devastate the functioning of the Federal Government.”
While the full extent of Corner Post’s impact will likely remain unseen without further litigation, Social Current will continue to monitor decisions referencing the verdict to understand the potential impact organizations might experience.
Moe v. Yost
On Tuesday, Aug. 6, a common pleas court judge ruled in favor of the constitutionality of an Ohio law. House Bill 68 was recently passed to ban minors’ access to gender-affirming care, including transgender surgeries and hormone therapies. It also restricts the type of mental health services minors can receive and precludes transgender women’s access to interscholastic sports according to the gender or sex with which they identify. Bicameral supermajorities overrode Governor DeWine’s veto, while the affirmative ruling allows the law to go into effect immediately.
The American Civil Liberties Union, the American Civil Liberties Union of Ohio, and the global law firm, Goodwin, filed the suit, with the intent of protecting transgender youths’ access to healthcare.
The American Civil Liberties Union of Ohio is preparing to appeal the decision, where it will reach the Tenth District Court of Appeal.
The Attorney General applauded the trial court’s decision, stressing the importance of protecting children “from making irreversible medical and surgical decisions about their bodies” while they are still growing.
Suits Social Current Is Monitoring
NetChoice, LLC v. Bonta, 9th Cir., No. 23-2969
NetChoice, is a trade association of online businesses that advocates for free expression and free enterprise on the internet. They recently challenged the constitutionality of California’s Age-Appropriate Design Code Act (CAADCA), which regulates the collection, storage, and use of minors’ personal data. CAADCA mandates that companies, like YouTube and Instagram, consider potential harm to children younger than 18 before implementing design features. Its regulations are intended to promote children’s online safety and privacy.
NetChoice sued the Attorney General of California to prevent the law’s implementation, which was granted by the US District Court for the Northern District of California. The Judge cited First Amendment concerns of how the law would impact speech, a decision that follows several Supreme Court decisions upholding the internet as an important forum for free speech.
California recently appealed the decision, which has since been heard by the U.S. Court of Appeals for the Ninth Circuit. While the lawsuit is pending, the judge suggested overturning the previous ruling, thereby allowing CAADCA to go into effect.
The ruling holds the potential to establish key precedent surrounding the viability of internet protections for children, especially following the strong bipartisan Senate passage of the Kids Online Safety Act (KOSA). KOSA similarly intends to prevent harm to minors on online platforms they are likely to use by defaulting to the safest settings possible for accounts perceived to belong to minors. For instance, a few proposed regulations include protections for users’ information, limited ability to communicate with minors, and restricted personalized recommendation features.
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