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Breaking News: Children's Health Act Sent to President
As we go to press, the U.S. Senate and House of Representatives have approved the Children's Health Act of 2000. The legislation includes several provisions that further the March of Dimes' mission to improve the health of infants and children by preventing birth defects and infant mortality.
Full details will be included in the next edition of Advocacy Update.
HHS Publishes S-CHIP Waiver Rules Eligible States Encouraged to Pursue Demonstration Projects
In an effort to find new ways to provide children with health insurance, the U.S. Department of Health & Human Services (HHS) is now encouraging States to request coverage expansion to other populations under its State Children's Health Insurance Program (S-CHIP). The Health Care Financing Administration (HCFA) recently issued the requirements for proposed demonstration projects under the authority of section 1115 of the Social Security Act. The purpose of S-CHIP 1115 demonstrations is to allow states to illustrate how State-initiated innovations, not otherwise permitted under the law, will help them accomplish the goals of the program. The guidance, issued on July 31, 2000, would allow states to obtain waivers under which income eligible pregnant women could be enrolled. This change in policy was an advocacy priority for the March of Dimes in 1999 and 2000.
"States can now request extended coverage that can give more pregnant women a chance to receive vital prenatal care," said March of Dimes president Dr. Jennifer L. Howse. "Section 1115 demonstration projects will provide states additional opportunities to develop innovative methods for expanding children's coverage, promoting participation in SCHIP and Medicaid, and improving the scope and quality of the services available to children."
For a demonstration project to be considered, states must have at least one year of experience providing child health assistance under S-CHIP and must have submitted all required evaluations and enrollment reports. A state will need to provide assurances that it has met the primary purpose of S-CHIP by expanding eligibility to low-income children (those families with incomes up to 200 percent of the Federal poverty level) and demonstrate that it is successfully reaching and enrolling eligible children. According to the guidance, states must expand Medicaid coverage for pregnant women up to 185% of the federal poverty level before using S-CHIP funds for further expansions.
All demonstration requests must identify demonstration objective(s) and include an evaluation component. The Department will not consider proposals that would reduce benefits for children below the minimum requirements of the law, or that would require cost sharing above the limits allowed by law.
March of Dimes Sets Public Affairs Issues and Year 2001 Priorities
This edition of the Advocacy Update presents the March of Dimes Public Affairs Issues and Priorities for 2001. This document was developed under the direction of the National Public Affairs Committee and approved at the Foundation's Board of Trustees meeting on September 8, 2000.
The purpose of the document is to guide chapters, states and the Office of Government Affairs in making decisions regarding allocation of volunteer and staff time and financial resources to public affairs activities. It is also intended to serve as a framework for 2001 public affairs plans and thereby help ensure that all March of Dimes chapters speak with one voice when discussing the Foundation's advocacy agenda.
Public Affairs Issues and Year 2001 Priorities
The March of Dimes Public Affairs agenda focuses on public policies and programs that relate to the Foundation's mission -- improving the health of babies by preventing birth defects and infant mortality -- and on issues that pertain to non-profit organizations. Public Affairs efforts are organized into the four general categories listed below (specific examples are listed for each category). A star in the left margin indicates that the issue is a Foundation-wide advocacy priority for the year 2001. Federal advocacy on any of the issues on this list may also require selective chapter participation.
I. ACCESS TO HEALTH CARE FOR PREGNANT WOMEN, INFANTS, AND CHILDREN
- Coverage for women, infants and children under Medicaid and the State Children's Health Insurance Program (S-CHIP) including amending S-CHIP to cover income-eligible pregnant women age 19 and older.
- Federal and state initiatives to expand newborn screening.
- Standards to protect the health of mothers and children enrolled in managed health care plans.
- Initiatives to prohibit genetic discrimination in health insurance, and to protect patient privacy.
- Federal and state initiatives related to maternal and child health care.
II. RESEARCH TO PREVENT BIRTH DEFECTS AND INFANT MORTALITY
Birth defects surveillance and research programs at the state, federal, and international levels; and specifically full implementation of the Birth Defects Prevention Act of 1998.
Research funded by the National Institutes of Health, the Centers for Disease Control and Prevention and other Federal agencies to increase knowledge relating to the prevention of birth defects and infant mortality.
III. PREVENTION PROGRAMS TO IMPROVE MATERNAL, INFANT, AND CHILD HEALTH
- Establishment of a new National Center for Birth Defects and Developmental Disabilities at the Centers for Disease Control and Prevention to provide national leadership in preventing birth defects.
- Preconception programs and services including increased use of folic acid.
- Food and nutrition education programs such as WIC - Supplemental Food Program for Women, Infants and Children.
- Substance abuse prevention and treatment for pregnant women and their babies.
- Programs to immunize infants and children, research to develop new vaccines, and efforts to eradicate polio worldwide.
- Programs to reduce exposure to environmental and reproductive hazards that are associated with birth defects.
- Adolescent pregnancy prevention programs.
IV. INSTITUTIONAL CONCERNS FOR NONPROFIT ORGANIZATIONS
- Federal and state laws and regulations related to non-profit organizations.
- Postal rate changes.
- Tax treatment of charitable contributions.
NC General Assembly Budget To Include Recurring Funds for Birth Defects Monitoring Program and Folic Acid Campaign
The North Carolina General Assembly has ear-marked funds specifically for birth defects surveillance, ensuring future support for the program which lost its' new funds in 1999 to disaster relief. The Assembly's 2000-2001 budget will include a $200,000 appropriation in recurring funds for the Birth Defects Monitoring Program and an additional $150,000 for a statewide folic acid campaign in non-recurring funds.
March of Dimes East Carolina Chapter volunteers helped secure passage of the Assembly's budget through various activities, including a series of meetings with legislators and state officials. To gain approval of the legislation, Chapter volunteers and staff worked with Rep. Mia Morris (R-NC) and Sen. William Purcell (D-NC).
"Our goal was to secure $350,000 for the Birth Defects Monitoring Program this year, and we more than exceeded that objective," said East Carolina Chapter Executive Director Kay James.
North Carolina Governor James Hunt has also committed to bring together maternal and child health experts to address the state's infant mortality and morbidity rates. State efforts to reduce infant mortality and morbidity will focus on folic acid education and the North Carolina Folic Acid Council.
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