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Senate Passes Fiscal Code Bills; Remaining Pieces of 2023-24 Budget Still Incomplete

While further activity recently occurred on the 2023-24 state budget, the months-long delay is not over. The state Senate returned to Harrisburg on August 30th to finalize the fiscal code, which dictates spending authority for funding contained in the 2023-24 budget. Two fiscal code bills, HB 1300 and SB 757, passed the chamber and are now in the hands of the House. HB 1300, the larger of the two bills, contains several less controversial provisions, including $14.5 million for Career and Technical Centers and almost $47 million to provide free breakfast to all public school students. This bill also includes the necessary language to reauthorize the state's hospital assessment, increased reimbursements for first responders, and funding for libraries and community colleges.

One concerning provision of HB 1300 that has alarmed early care and education advocates is language requiring monthly reporting by Pre-K Counts providers to PDE and language requiring PDE to "claw back" or recover funds within 15 days of receipt of a report in certain circumstances. These changes to the Pre-K Counts program would create an undue burden for providers and create operational issues for programs that will impact both teachers and the children they serve. PPC joined the Pre-K for PA campaign to speak out against the amended language in HB 1300 and is currently working with the House to ensure it is not included in a final fiscal code bill.

SB 757 includes authorization for the private school voucher program, referred to as the Pennsylvania Award for Student Success, and increases funding for the state's Educational Improvement Tax Credit (EITC).

The House is expected to return to Harrisburg on September 26th after the special election on September 19th to fill the seat vacated by former Rep. Sara Innamorato, who is running for Allegheny County Executive. The election will determine party control of the House, which currently sits at a 101-101 even party split. It is unclear whether the House will take up or amend either bill.

Separate from the Senate movement on the fiscal code, both chambers have been active this week with hearings of the Basic Education Funding Commission. The Commission was reconstituted earlier this year following a decision from the Commonwealth Court that found Pennsylvania's school funding system is inadequate. Hearings this week are occurring in Allentown, Harrisburg, and Philadelphia. Later this month, hearings are scheduled for Lancaster and Hanover, with more dates planned for October. Details on upcoming agendas and testimony are on the Basic Education Commission website. Stay tuned for recaps of these meetings and future commission meeting dates. HB 1300 does contain language requiring the Commission issue an interim report by January 30th, 2024, and a final report by April 30th, 2024.

Evidence-Based Home Visiting Models Highlighted in Fayette County

The Childhood Begins at Home campaign's event in Fayette County highlighted the two evidence-based models operating there: Parents as Teachers and Early Head Start. Sen. Pat Stefano, who represents the area and recently became co-chair of the Early Childhood Education Caucus, participated in the event at the Fay-Penn Economic Development Council.

President and CEO Kari King moderated and was joined by representatives from the two models—they spoke about the history of the programs in the area and the research-proven positive outcomes resulting from home visiting services. A parent receiving services from Parents as Teachers shared her personal experience, and other speakers included Fayette County Sheriff James Custer, Fayette County Assistant District Attorney Melinda Dellarose, and Fayette County Commissioners Vincent Vicites and Scott Dunn.

King lauded the historic investment in last year's state budget, where $24 million in additional funds were invested in the state's two home visiting line items. While the Childhood Begins at Home campaign requested level funding for the 2023-24 budget, future support is needed from state policymakers, as only 7% of low-income children under 6 receive home visiting services in Pennsylvania. In Fayette County, 602 children are served by publicly-funded, evidence-based home visiting programs, or 19% of low-income children under 6.

CMS Warns States to Fix Automated Renewals During Medicaid Unwinding

In an August 30th letter, the Centers for Medicare & Medicaid Services (CMS) warned all states to assess and fix their eligibility systems so eligible children and their families can remain enrolled in Medicaid.

The issue is how some states have been conducting automated renewals, also known as "ex parte" renewals, during the unwinding process that are causing improper disenrollments for those still eligible, especially children.

CMS believes the problem lies in how states conduct automated renewals at the household level instead of at the individual level, most likely because parents have different eligibility requirements than their children. If a parent's eligibility cannot be completed automatically at the household level, neither can their child's.  

DHS is sending renewal packets to households that haven't renewed automatically. Unfortunately, there is concern that parents who are no longer eligible may also believe their child is no longer eligible for coverage. Not returning this paperwork results in loss of coverage.

In Pennsylvania, younger children have higher eligibility thresholds than their parents. For example, babies under 1 are eligible up to 215% FPL, children ages 1 through 6 are eligible up to 157% FPL, and older children and adults are eligible up to 133% FPL.

CMS requires states to "immediately act to correct the problem and reinstate coverage."

As reported in our last newsletter, it is alarming that more than half of the 38,000 Pennsylvania children who have lost Medicaid coverage since the unwinding began in April are for these procedural reasons.

With Pennsylvania's historically low use of conducting renewals on an ex parte basis, the CMS requirement is welcome news. 

Conducting automated renewals for children, even if their parents are no longer eligible, would be a huge step toward keeping kids covered.

In the News:

NYT: Many Children May Have Lost Medicaid Coverage Because of State Errors

CCF blog: Breaking News: CMS Reveals States are Incorrectly Processing Ex Parte Renewals; Kids are Most at Risk

90.5 WESA: Thousands of Pennsylvanians have lost Medicaid coverage since end of COVID-era rule

Did You Know?

In Case You Missed It...

• Policy Director Maggie Livelsberger discussed with Keystone State News Connection our State of Early Care and Education in Pennsylvania report and how more access to quality pre-k programs is needed for the youngest Pennsylvanians.
• An investigation by the Lehigh County Controller uncovered systemic overdiagnosis of medical child abuse, with the northeastern region accounting for 40% of referrals despite having only 14% of its population under 18. Included in the investigation report are recommendations for reform, like obtaining second opinions of medical child abuse diagnoses and unbiased reviews before substantiating reports.
• The University of Pennsylvania Carey Law School and Temple University Beasly Law School co-authored a report highlighting how black families are overrepresented in every step of the investigatory process in the ChildLine registry.
• Registration is now open for the Pennsylvania Council of Children, Youth, and Families' Education Summit. The October 17^th event focuses on presentations on educating youth in foster care.
• Pennsylvania's Prenatal-to-Age-Three Collaborative seeks feedback from families of infants and toddlers on critical services to their families. This feedback will help identify policy solutions to help make Pennsylvania the best place to raise a family. We need input in the following counties: Cambria, Erie, Fayette, Lackawanna, Lawrence, Luzerne, Northumberland and Philadelphia. Please circulate this survey to families that may be interested!
• A recent study by the Pennsylvania Health Cost Containment Council found that women with severe maternal morbidities increased by 40% between 2016-2022. The study found morbidities increased by over 50% for Black and non-Hispanic patients.
• Pennsylvania ranked 24^th in a recent report by WalletHub that looked at 2023's Best & Worst States to Have a Baby. The report compared all 50 states and the District of Columbia across over 30 measures, looking at cost and health care accessibility, as well as baby- and family-friendliness.
• Zero to Three released Babies in the Budget: Federal Share of Spending on Infants and Toddlers FY2017-FY2023. The brief shows federal spending amounts for children birth to age three equates to only 1.5% of all spending even though they make up 3.4% of the U.S. population. Funding for infants and toddlers has also declined as a share of the federal budget since FY 2017.