Public Policy 2009 - Generations United

Generations United Public Policy Agenda for the 113th Congress

Generations United Board of Directors CHAIR William L. Minnix, Jr. President & CEO LeadingAge VICE CHAIR Matthew E. Melmed Executive Director ZERO TO THREE SECRETARY Michael S. Marcus Program Director The Harry and Jeanette Weinberg Foundation TREASURER Paul N. D. Thornell Vice President, Federal Government Affairs Citigroup, Inc. BOARD MEMBERS MaryLee Allen Director, Child Welfare and Mental Health Children's Defense Fund Mary Ann Casey The Patton Family Foundation Sharon Fine Senior Vice President AON Jatrice Martel Gaiter Executive Vice President of External Affairs Volunteers of America Walter L. Jones Vice President Network - West Area Verizon Wireless

Barb Quaintance Senior Vice President Office of Volunteer and Civic Engagement AARP Pamela B. Smith Director, Aging & Independence Services County of San Diego, Health and Human Services Agency James Taylor President, Senior Living Sodexo, North America Sandra Timmermann Director MetLife Mature Market Institute Marla Viorst Communications Consultant

Stephanie Osborn Director of Strategic Initiatives National Association of Counties

Marsha Adler Senior Fellow Colleen Appleby-Carroll Communications Coordinator Ana Beltran Special Advisor National Center on Grandfamilies Leah Bradley Program Specialist Adam Hlava Operations and Grants Manager Jaia Peterson Lent Deputy Executive Director

STRATEGIC ADVISORS Robert Blancato President Matz, Blancato, & Associates Robert Dugger Managing Partner Hanover Investment Group James Firman President & CEO National Council on Aging Marc Freedman President Encore.org Irv Katz President & CEO The National Human Services Assembly Catherine Milton

Sandra Nathan Vice President for Programs Marin Community Foundation

STAFF Donna M. Butts Executive Director

John Rother President & CEO National Coalition on Health Care Mary Ann Van Clief Vice President The Brookdale Foundation Group Juan Williams Fox News Correspondent and Journalist

Sheri Steinig Deputy Executive Director Tom Taylor Special Advisor, Seniors4Kids Bettina Thorpe-Tucker Office Assistant

Generations United

Public Policy Agenda for the 113th Congress

March 2013


Letter from the Chair and Executive Director We are proud to present Generations United’s Public Policy Agenda for the 113th Congress. This agenda is the result of a thoughtful and thorough development process undertaken by the Generations United Public Policy Committee, Board of Directors, and staff. Generations United is the national membership organization focused solely on improving the lives of children, youth, and older people through intergenerational strategies, programs, and public policies. Since our inception in 1986, Generations United has served as a non-partisan resource for educating policymakers and the public about the economic, social, and personal imperatives of intergenerational cooperation. Intergenerational cooperation among policymakers, organizations, and advocates who care about children, youth, older adults, and vulnerable families is particularly important as the country’s economic problems continue to mount. The legislative priorities described in this agenda are viewed through an intergenerational lens. Within these priorities, Generations United will emphasize policies and programs that meet critical needs during current fiscal challenges and needed long- term investments in all generations that will help our country move toward a more stable and secure future. Our nation faces immediate challenges, including focused efforts to address structural budget deficits (such as the sequestration provisions of the Budget Control Act of 2011). However, our efforts to address these challenges must not jeopardize vital supports for children, families and older adults-- many of which already have suffered serious cuts. Additionally, any proposals to address the long-term fiscal outlook for Social Security and Medicare must respect existing commitments, ensure long-term stability, and be conducted in a way that does not create conflict between generations or support programs. While we continue to address immediate challenges and lay the groundwork for long-term fiscal stability, we must engage in a respectful and ongoing discussion about the changing demographics of our nation. As the baby boomer generation ages and as new immigrant and racial/ethnic minority populations grow, we must continue to ensure that we can support our most vulnerable

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populations – regardless of their age or background. Programs and opportunities to foster intergenerational and cross-cultural contacts will promote better understanding across the demographic spectrums, as well as provide tangible benefits for our nation’s ability to care for and protect all of its people. We commend the co-chairs of the Public Policy Committee, Amy Gotwals, Senior Director of Public Policy and Advocacy for the National Association of Area Agencies on Aging, and Hayling Price, Policy Director for the National Human Services Assembly, as well as outgoing co-chair and current Committee member Jennifer Dexter, Assistant Vice President, Government Relations for Easter Seals. They provided critical leadership in the creation of an agenda that represents the shared concerns of young and old and the promotion of innovative intergenerational approaches. In addition, we would like to thank the committee members who worked diligently to develop the priorities and language presented in this agenda. And finally, thank you to Generations United current and former staff, in particular Eric Masten, Melissa Ness, and Jaia Peterson Lent of the policy team, who provided ongoing support to the committee in the development of the agenda and leadership for furthering the objectives of the agenda, and to Ana Beltran for her expertise in policies affecting grandfamilies. Generations United will use this public policy document as a basis for strong educational and advocacy efforts to promote intergenerational public policy and create a world that values all generations. Why? Because we’re stronger together.

Larry Minnix

Donna Butts


Table of Contents Introduction to Generations United ....................1 Generations United Public Policy Committee Statement......................................................2 About the Generations United Public Policy Agenda..........................................................4 Intergenerational Principles ...............................4 Legislative Action Priorities During the 113th Congress.......................................................6 Legislative Priority Areas Supports for Grandfamilies and Other Family Caregiving Intergenerational Intersection........................8 Position Statement ........................................8 Implementing the Fostering Connections to Success and Increasing Adoptions Act.........9 Keeping Families Together ..........................11 Permanency Incentives ...............................12 Health Care and Education .........................13 Respite Care ...............................................15 The National Family Caregiver Support Program .....................................................16 Child Care ...................................................16 Data Collection............................................17 Immigration .................................................17 Social Supports Intergenerational Intersection......................18 Position Statement ......................................18 Older Americans Act ...................................18 Corporation for National and Community Service ........................................................19 Social Services Block Grant........................20 Child Welfare Services ................................21 Elder Justice................................................22 Nutrition Programs ......................................23 Education ....................................................24 Livable Communities Intergenerational Intersection......................28 Position Statement ......................................28 Housing .......................................................28 Shared Sites ...............................................28

Sustainable Communities for All Ages ........29 Transportation .............................................29 Workforce....................................................30 Technology ..................................................31 Income Supports Intergenerational Intersection......................32 Position Statement ......................................32 TANF Block Grant Reauthorization .............33 Child Support ..............................................34 Social Security ............................................35 Minimum Wage ...........................................36 Poverty Measurements ...............................37 Unemployment and Unemployment Insurance ....................................................37 Family and Medical Leave...........................38 Nutrition Assistance Programs....................39 Low Income Home Energy Assistance Program ......................................................40 Health Care Intergenerational Intersection......................41 Position Statement ......................................41 Affordable Care Act .....................................41 Medicare, Medicaid, and State Children’s Health Insurance Program (SCHIP)............42 Long Term Services ...................................44 Mental Health Services ...............................45 Health Care for Children and Youth.............45 Tax and Budget Issues Intergenerational Intersection......................47 Position Statement ......................................47 The Economic Environment ........................47 The Child Tax Credit....................................48 Caregiver Tax Credit....................................49 Earned Income Tax Credit (EITC) ...............49 Adoption Tax Credit .....................................49 References ......................................................51 © Generations United, 2013 Reprinting with permission only. Generations United 1331 H Street, NW, Suite 900 Washington, DC 20005

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Introduction to Generations United

people through

enerations United is the national membership organization focused solely on improving the lives of children, youth, and older people through intergenerational strategies, programs, and public policies. Since 1986, Generations United has served as a resource for educating policymakers and the public about the economic, social, and personal imperatives of intergenerational cooperation. Generations United acts as a catalyst for stimulating collaboration between aging, children, and youth organizations, providing a forum to explore areas of common ground while celebrating the richness of each generation

intergenerational

Our Mission:

G Mission:

To improve the lives of children, youth, and older

collaboration, public policies,

To improve the lives of children, youth, and older people through intergenerational collaboration, public policies, and programs for the enduring benefit of all.

and programs for the enduring

Our Vision:

benefit of all.

A world that values and engages all generations.

Our Role: To act as a catalyst that fosters innovation in programs and policies that grow and lead the intergenerational field.

Core Beliefs: Generations United is the catalyst that brings single-age focused groups together to build and support a common agenda while providing a unique voice in public debate. Generations United honors all ages, supports all ages, and engages all ages. Further, we believe:

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• Intergenerational collaboration unites and improves our communities • Intergenerational approaches have a positive relationship to economic growth and value creation • Public policy should meet the needs of all generations • Resources are more wisely used when they connect the generations rather than separate them • Discrimination, in any form, limits a person's potential to contribute to the development of their community • Grandparents and other adults who step forward to raise children are keeping families together and providing an economic service to our country


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Generations United Public Policy Committee Statement enerations United is the organization that brings single-age focused groups together to promote a common agenda on behalf of children, youth, and older adults. We believe public policies should meet the needs of all generations, and resources are more wisely used when they connect generations rather than separate them. This intergenerational approach to framing public policies is especially important now as the country faces serious economic challenges. The need for programs and services that help children, older adults, individuals with disabilities, and low-income families better cope with the effects of this recession is acute. The economic downturn has affected millions of people and caused widespread hardships such as unemployment, homelessness, and deepening poverty. Unfortunately, downward pressure on state and local budgets has resulted in severe cuts, many in critical human services. Popular perception suggests groups who represent the interests of children and seniors should be at odds over public policy since relationships between young and old are based on competition for scarce resources, fostering conflict between the generations. We object to using the argument of generational inequity as a way to divide generations and believe that sound public policy must not be based on caricatures or stereotypes. Our goal is to help policymakers and the public understand that generational interdependence, or reciprocity between generations, is the reality in which we all live. Public policies should protect and encourage the mutual giving and receiving of resources, which have been characteristic of societies throughout time. Recognition of our generational interdependence will help us prevail over difficult economic conditions, promote social progress, and ensure future economic stability.

G

There are many examples of short- and long-term strategic investments that can strengthen the economy and society by improving the lives of children and older people. Federally supported hunger and nutrition programs produce benefits for all ages, and especially for children and older adults. Adequate nutrition helps children and youth concentrate in class, improves their memory and overall behavior, and leads to better health and fewer visits to the doctor. For older adults, access to good nutrition also improves memory, helps maintain healthy physical activity, and reduces the number of trips to the doctor. Better schools and effective and dynamic education programs will cultivate a skilled and productive work force that can support those who are not working because of their youth, disability, and retirement. A child welfare system that fully and robustly supports the millions of children being raised by grandparents and other relatives will result in better outcomes for our most vulnerable children and families. The new investments in preventive health care and the management of chronic diseases will help us meet long-term economic challenges. A sound Social Security program is more than a retirement program for older adults; it also provides benefits for disabled workers, their families, and millions of children through survivor benefits or as a part of their primary caregiver’s income. Generations United seeks to build on common concerns for educational and employment opportunities, access to comprehensive physical and mental health care, economic security in good times and bad, and long-term fiscal and social stability. Generations United supports full funding for the programs and policies described in this Agenda, which require adequate and

Recognition of our generational interdependence will help us prevail over difficult economic conditions, promote social progress, and ensure future economic stability.

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"The moral test of government is how the government treats those who are in the dawn of life, the children; those who are in the twilight of life, the elderly; and those who are in the shadows of life the sick, the needy, and the handicapped."

Hubert Humphrey

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sustained revenues to ensure their continued quality and access. Critical human service programs such as Medicaid, Federal foster care, child welfare and protection, early childhood and K-12 education, Head Start and Early Head Start, and housing and nutrition programs must be protected for the children, older adults, and families who need them. Further, the level and quality of services should be continually monitored for potential adjustments that can improve outcomes for vulnerable children and families. Since 1986, Generations United has been the only membership organization in the country focused solely on improving the lives of young and old together by promoting intergenerational strategies, programs, and

public policies. Our diverse constituency includes more than 100 national organizations, numerous state and local coalitions, and individuals. Currently, 15 organizations representing those who serve younger and older constituencies serve on the Generations United Public Policy Committee under the leadership of Amy Gotwals, Senior Director of Public Policy and Advocacy for the National Association of Area Agencies on Aging, and Hayling Price, Policy Director for the National Human Services Assembly.


About the Generations United Public Policy Agenda Issues Included in this Agenda Although Generations United supports a wide range of policies that are consistent with the intergenerational approach, we work to carefully limit our focus to those areas that are distinctly intergenerational, timely, and/or in clear need of leadership. While this Agenda was created to represent current key intergenerational issues of concern to Generations United members, additional issues may arise over time.

Determining if Public Policy Issues are Intergenerational Issues Generations United recognizes a public policy issue as intergenerational when it either: • Incorporates an intergenerational approach to addressing an issue, or • Has an impact across the generations

Intergenerational Principles & Determining if Public Policy is Sensitive to All Generations The goal of this Generations United Agenda is to promote public policies that use an intergenerational approach and shape other key policies to be supportive of intergenerational reciprocity. Public policies are intergenerational when they view people of all ages as a resource, promote the interdependence of the generations, are sensitive to intergenerational family structures (e.g., grandparents who are raising grandchildren), and encourage intergenerational transfers through shared care or services. Generations United recommends that policymakers and advocates use the following four principles as a guide against which legislation can be measured to determine if policies are truly intergenerational: • Make lifetime well-being for all the highest priority. • Consider the impact of every action on each generation. • Unite rather than divide the generations for the greatest social and financial impact. • Recognize and support every generation’s ability to contribute to the well-being of their families and communities. Generations United will use the principles above to assess the intergenerational impact of legislation and policies. Corresponding to the principles, a model intergenerational law or policy will: • Use innovative or proven approaches to improve lifetime well-being for all generations. • Include an assessment of both short term and long-term impacts on each generation and demonstrate benefits for multiple ages. • Actively promote innovative and proven strategies to unite two or more generations • Actively promote innovative and proven strategies to support and engage every generation’s ability to contribute to the well-being of their families and communities.

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Legislative Action Priorities during the 113th Congress Generations United identifies, promotes, and outlines the following legislative priorities for the 113th Congress and will advance them through leadership, partnership, and supportive actions. Consistent with these priorities, Generations United will advocate for policies and programs that meet the needs of children, youth, and older adults in the current economic crisis and critical investments that build toward a more stable and secure future for all generations.

Leadership Generations United will take a leadership role in the first tier priorities. Issues in this category will receive the highest possible attention from Generations United where appropriate and feasible. We will advocate for these priorities before Congress and the Administration, organize and participate in Hill visits and other public education activities, initiate sign-on letters and host briefings. Generations United’s leadership priorities are: • Protect and improve the adequacy of Social Security so it continues to meet its obligations to current and future beneficiaries, including the more than 30 percent who are under 65 and receive disability and/or survivors’ benefits. • Protect, strengthen and expand proven hunger and nutrition programs such as the Supplemental Nutrition Assistance Program, and promote innovative intergenerational approaches to meeting hunger needs such as those in shared sites where children and seniors interact and share resources.

Partnership These are areas in which Generations United will partner with coalitions to achieve our goals, but will not take a leadership role. As resources permit, we will advocate before Congress and the Administration, co-sponsor briefings and sign-on letters, monitor legislation

and inform members. Generations United’s partnership priorities are: • Ensure that appropriate funding is not reduced, and that federal and state tax and budget policies provide sufficient revenues, to maintain crucial programs for all generations, including those that promote health security and well-being, retirement savings, and sustainable Medicare and Social Security. • Ensure that language is included in the reauthorization of the Elementary and Secondary Education Act that promotes intergenerational collaboration and facilitates the transition of more schools into intergenerational shared spaces. • Reauthorize the Older Americans Act to strengthen multigenerational civic engagement programs, promote opportunities for intergenerational programs and shared sites, and encourage states to use National Family Caregiver Support Program funds to serve grandfamilies. • Support federal funding and incentives for states to invest in quality early childhood education for all children ages birth to five, including child care, Early Head Start, Head Start, and Pre-K (through reauthorization of the Elementary and Secondary Education Act). • Ensure policies are in place that will help guarantee children and their relative caregivers fully benefit from the services and protections in the Fostering Connections to Success and Increasing Adoptions Act, and advance policy goals that support grandfamilies and other relative caregivers who are not supported by the formal foster care system.

Support Generations United stands by the additional issues in this Public Policy Agenda.

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Photo by Denzell Mitchell


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Supports for Grandfamilies and Other Family Caregiving Position Statement Generations United supports public policies that assist family caregivers of all types in caring for family members. Familyfriendly national policies will require eliminating barriers to eligibility in current programs, expanding programs to allow greater access, and creating new programs to address the continuing growth in intergenerational caregiving. Policies should place special emphasis on assisting families with low to moderate incomes and limited assets, in addition to other vulnerable populations.

Intergenerational Intersection aregiving unites the generations.

C

Whether a grandparent is raising a

grandchild or an adult child is caring for an aging parent, the wellbeing of two, and sometimes three or more, generations is inextricably linked. The interdependence of family

Family caregivers

members is also evident during periods of

make

economic insecurity, when families must meet

tremendous

basic needs with diminishing resources. In

contributions

order for these families to achieve stability

and often make

and flourish, the needs of both caregivers and

Issues and Recommendations Grandparents and Other Relatives Raising Children Intergenerational family caregiving of all kinds is on the rise. An increasing number of adults are caring for aging parents or other relatives, often at the same time they are raising their own children. In addition, grandparents and other relatives are stepping in to help raise their grandchildren, nieces, nephews, and other related children. All of these family caregivers make tremendous contributions and often make serious sacrifices to keep their families together. If not for their efforts, millions of children and other relatives would be denied the opportunity to remain in stable, loving homes. According to the 2010 Census, there are nearly 7 million children living in grandparentor other relative-headed households, also 1 known as grandfamilies. Almost 2.9 million of these children are living with grandparents who report they are “responsible” for these children. More than 919,000 of these grandchildren whose grandparents are responsible for them also have no parents 2 present in the home.

those cared for must be considered.

serious sacrifices to keep their families together. If not for their

The reasons causing these children to live with their grandparents and other relative caregivers —parental death, substance abuse, financial issues, military deployment, incarceration, mental illness—can happen to anyone, so we find these families in every area in the country and of all races and ethnicities. The data concerning grandparent caregivers mirror that of the children they and other relatives raise: 51 percent of the grandparents are White (alone, not Latino); 22 percent are Black or African-American; and 20 percent are of Latino origin of any 3 race. The vast majority, over 1.8 million, are 4 age 59 or younger. Twenty-one percent of these grandfamilies are living below poverty and more than 60 percent are still in the 5 labor force. Census Bureau data also show that children being raised by grandparents and other relatives are more likely to have disabilities than children in parent-headed 6 households. The weight of the evidence suggests that children in formal kinship care have lower rates of mental health and

efforts, millions of children and other relatives would be denied the opportunity to remain in stable, loving homes.

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Grandparents and other relativecaregivers perform an extraordinary service that allows hundreds of thousands of children to maintain vital ties to their families while simultaneously easing the burden on the public child welfare system.

behavioral problems than their peers in foster care, but higher than children in informal kinship care and the general population. Children’s problems are primarily attributable to exposure to trauma prior to placement with kin and functioning improves (on average) over time, controlling for functioning at initial 7 “placement.” Grandparent caregivers often face a range of physical and mental health 8 concerns themselves as well. Grandfamilies can be found both inside and outside of the child welfare system. Placements with relatives in foster care account for over a fourth of the children in child welfare. Despite that large percentage, the number --- about 107,995 -- is very small when compared to the number of children being raised by relatives outside of the foster care system. Grandparents and other relative-caregivers perform an extraordinary service that allows hundreds of thousands of children to maintain vital ties to their families while simultaneously easing the burden on the public child welfare system. The Fostering Connections to Success and Increasing Adoptions Act of 2008 (Fostering Connections Act) is expanding access to services and financial supports that are so urgently needed for grandfamilies within and outside the foster care system. For more information about grandparents and other relatives raising children, visit www.gu.org or contact Generations United to obtain our fact sheets and other publications.

Implementing the Fostering Connections to Success and Increasing Adoptions Act Recommendations • The Fostering Connections to Success and Increasing Adoptions Act (P.L. 110-351), enacted in 2008, provides broad support for children and their relative caregivers. It is critically important that the Department of Health and Human Services and committed

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advocacy and service groups work together to ensure that relative caregivers and the children they are raising fully benefit from the services and protections in the Act • Work with states to encourage all states take advantage of the Guardianship Assistance Program (GAP) option, and assist those already implementing GAP to identify and reach all eligible children and relative caregivers and support them in a manner that is consistent with the needs of the children and those relatives raising them. • Work with the Department of Health and Human Services to ensure that, through the Adoptions and Foster Care Analysis and Reporting System (AFCARS) and other accountability systems, HHS will have the data needed to help assess the impact of the new services and supports for grandfamilies.

Statewide Kinship Navigator Programs The Fostering Connections Act authorized a new grant program, called the Family Connection Grants, which is designed to connect children in, or at risk of entering, foster care with family. Many of the activities funded under the Family Connection Grants help identify and support grandparents and other relatives raising children, including funding reserved for kinship navigator programs. Statewide kinship navigator programs are toll-free hotlines, help desks or one-stop- shopping locations that help connect families to existing benefits programs, local support groups, respite care programs, and other useful government and nonprofit services. These programs respond to grandfamilies’ need for streamlined access to information about the existing programs and services available to their families. The Fostering Connections Act guarantees $5 million in funds annually for

Supports for Grandfamilies and Other Family Caregiving

grants for kinship navigator programs for five years from fiscal year (FY) 2009-FY2013. Funding for these programs will help grandfamilies better use existing programs and provide a centralized mechanism for creating partnerships between government, nonprofit, and community- and faith-based agencies to serve the needs of these families. The first of these grants were awarded on September 30, 2009. Six grants were awarded to fund Kinship Navigator Projects in four states (California, Minnesota, New Jersey, and Ohio) though not all are statewide. Seven additional grants were awarded to projects in California, Maine, Maryland, Oklahoma, Rhode Island, South Carolina, and Washington to fund Kinship Navigators in combination with other projects such as Family Finding and/or Family Group Decision-Making. Again, not all are operating statewide. A second round of Family Connection Grant projects were awarded in September 30, 2011, for projects focused on Family Group Decision-making, a process that engages families in building capacity to meet their children’s needs by strengthening protective factors and reducing risk factors for child maltreatment. Family Group Decision-making provides an important opportunity to bring relatives together with parents to discuss the best supports for the children. Family Connection Grants were also awarded for fiscal year 2012 to projects in Arizona, California, Florida, Michigan, New York and Oklahoma to implement kinship navigator programs in collaboration between child welfare and Temporary Assistance for Needy Families (TANF) agencies. Each of the programs is undergoing evaluation to demonstrate its effectiveness in meeting the needs of the families it serves.

Guardianship Assistance Program (GAP)

monies through Title IV-E of the Social Security Act to finance Guardianship Assistance Program (GAP) payments for children cared for by relative foster parents who are committed to caring permanently for these children when they leave foster care. The new law allows thousands of children to exit foster care into loving, stable, and permanent homes with relatives. Generations United strongly encourages all states to take advantage of the new federal supports for children in foster care and their relative caregivers. As of December 2012, 29 states and the District of Columbia and the Port Gamble S’Klallam Indian Tribe in Washington state had applied to and been approved by the Department of Health and Human Services (HHS) for federal funding for the new Title IVE Guardianship Assistance Program. All are now working to implement GAP in order to help children leave foster care and move to permanent homes with relatives. Many of the states that have opted to implement GAP have seen benefits in promoting permanency for children and youth in foster care, maintaining family connections, helping sibling groups stay together, and respecting cultural and tribal norms. Two additional states, Virginia and Indiana, have also submitted state plan amendments to HHS requesting GAP funding and are awaiting approval. While the GAP payments are only available to some of the children being raised by relative caregivers in foster care, and not to children with caregivers who are helping to keep them out of foster care, they are an important first step in recognizing the invaluable work of all relative caregivers. Generations United supports additional efforts to support relative caregivers, including those outside the formal foster care system.

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While the GAP payments are only available to those in foster care, they are an important first step in recognizing the invaluable work of all relative caregivers.

The Fostering Connections Act gives states the option to use federal child welfare

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Identification and Notification of Relatives When a Child is Placed in Foster Care

“The closest friends I have made all through life have been people who also grew up close to a loved and living grandmother or grandfather.”

Margaret Mead

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The Fostering Connections Act requires agencies to exercise due diligence to identify and notify all grandparents and other adult relatives within 30 days of a child’s removal from his or her parents’ custody. By requiring identification and notice, the Fostering Connections Act seeks to involve relatives earlier in the process and tries to ensure that children can maintain connections to their family, whether through placement, visits or other ongoing involvement. The notice requirement also requires states to explain to relatives how to become a foster family home, the additional services and supports that are available for children in such a home, and information about how to enter into a GAP payment agreement if it is available in that state. This information helps relatives make informed decisions about how they can best support their relative children by either helping to keep them out of foster care or by using available services to care for them with the support of the child welfare system. There are countless compelling stories from around the country of relatives who did not know that their grandchildren, nieces, nephews or siblings had been placed into foster care until well after they had been placed or even adopted by a non-relative. Federal law has required for several years -as a prerequisite to receive funding for child welfare services -- that states “consider giving preference to an adult relative over a non-related caregiver when determining placement for a child, provided that the relative caregiver meets all relevant state child protection standards.” Even those states that give preference, however, do not identify or notify relatives when children are removed from their parents’ homes. The identification and notice requirement should

work in unison with relative placement preferences to help grandfamilies come together. They will also, in turn, enable more children and families to benefit from GAP. Generations United will continue to provide technical assistance to the states to encourage more to properly implement these important federal requirements.

Licensing Standards for Relative Foster Parents and Housing Challenges The Fostering Connections Act clarifies that states may waive non-safety licensing standards on a case-by-case basis in order to eliminate barriers to placing children safely with relatives in licensed homes. Certain licensing standards can create barriers to relatives becoming foster parents for children when they wish to do so. Requirements for a separate bedroom for each child, or meeting certain square footage requirements, may not be appropriate for foster parents who are related to the child, or they may be outweighed by the benefits of placing a child with a relative in order to maintain family connections and lessen the trauma of removal. Generations United, working closely with the American Bar Association Center for Children and the Law, has researched licensing standards for foster family homes in all 50 states and the District of Columbia, identified trends, and barriers that restricted access to relatives, and is now building on the research to develop model “core” standards that address the health and safety of the children being cared for.

Keeping Families Together Recommendations • Expand and improve federal support for preventive, specialized treatment, and postpermanency services before children enter foster care, while in care, or when they are returned home, placed permanently with relatives or adopted to improve outcomes for the children.


• Support efforts to keep families and grandfamilies in their homes and provide assistance to grandparents and other relative caregivers (who own and live in their own homes) to build additional space to accommodate the children who have unexpectedly come into their care. In 2010, more than 677,000 children 9 were identified as abused or neglected. The true incidence of maltreatment is estimated to be up to three times higher. The capacity to help even those whose maltreatment is detected is sorely lacking. Of those children whose abuse is reported and substantiated, nearly 40 percent receive no services at all after the investigation—not foster care, 10 counseling or family supports. Those who do receive services are often not adequately supported. When a child has been abused or neglected and cannot remain safely at home, the federal government guarantees support for room and board for many of these children in foster care, with adoptive parents or -- at state option -- with relatives who have taken guardianship. The federal government however does not guarantee support for services to prevent abuse and neglect and to keep children safely with families and out of foster care in the first place. Nor does it offer supports to children who enter care so they can move promptly back home, to new permanent families, or with relatives where appropriate. Expanding investments in these areas will allow grandparents and other relatives caring for children - whether they step in before the child is removed from his or her parents or when a child is placed in foster care - to access services and supports such as respite, and/or mental health treatment for themselves and their children. Generations United works with a coalition of groups to develop a child welfare financing proposal that will improve outcomes for children by offering federal support for a full continuum of services for children when they

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first come to the attention of the child welfare system so they can be assured of a safe permanent family, with their birth family, relative, or other permanent family. For those grandfamilies both inside and outside of the foster care system, many are finding it especially difficult to stay in their homes. According to a 2007 report from the U.S. Department of Housing and Urban Development, grandfamilies face housing challenges similar to those of single-parent families and families with children who have disabilities. Grandfamilies who have to leave their current homes may have difficulty finding new ones for many reasons, including the fact that many senior residences do not allow children. Policies facilitating the creation and maintenance of housing specific to grandparents raising grandchildren with onsite services is one helpful response to these challenges, as are programs that would allow grandfamilies to build additional space onto their existing home in order to accommodate the children who have unexpectedly come into their care.

Permanency Incentives Recommendation • Create a Permanence Incentive Program, based on the concept of the Adoption Incentive Program that will recognize two other types of safe and stable permanence: guardianship and reunification with the child’s family of origin. The Adoption Incentives Program established by the Adoption and Safe Families Act of 1997 and reauthorized for the second time by the Fostering Connections Act provides incentive payments to states that increase the number of adoptions of children from the public child welfare system. States report they have used their incentive payments to recruit and train adoptive families and provide post-adoption services. The program has yielded significant

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Photo by Daly City

increases in adoptions since its implementation. Since the program began in 1998, more than 650,000 adoptions from foster care have been finalized. As currently structured, however, the adoption incentive program does not recognize other valuable forms of permanency for children in foster care – reunification with their birth families and the permanent placement of children with relatives, through guardianship or other means. Generations United is continuing to work, as part of its work on broader child welfare financing reform, to reward states that increase permanency of children in several different ways, not just by adoption.

Health Care and Education Recommendations • Eliminate barriers that keep grandparents and other relative caregivers from enrolling

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children in school and accessing certain key services for the children in their care such as physical and mental health services and school services, including special education early intervention, and early care and learning programs. • Expand and improve mental health services for grandparent and other relative caregivers and the children they are raising. While grandfamilies often face a host of financial, housing, legal, and emotional problems, they are ineligible for many of the services to which similarly situated families with biological parents are entitled. Grandfamilies also face a range of special physical and mental health challenges, and, the health problems of caregivers and care recipients can affect one another. Legal custody requirements, which vary


widely by state, are a particular challenge and often ignore the role grandparents and other relatives play today in raising and nurturing children. For example, it is often difficult for grandparents to obtain medical treatment for children in their care. Many insurance companies refuse to allow a grandparent to include a grandchild as a dependent on his or her insurance policy unless that grandparent has adopted the child or has legal custody or guardianship. Many schools refuse to admit children living with grandparents unless one of the parents is living in the household or the grandparent is the legal guardian. While many states have enacted educational consent and/or medical consent laws that allow kinship adults to enroll children in school and make other health decisions on their behalf, there are also states that do not have laws in place to 11 support these families. From July 1, 2006, Medicaid beneficiaries were at risk of losing their health benefits if they were unable to prove their U.S. citizenship. Although many helpful changes to the requirement were implemented by the Tax Relief and Health Care Act of 2006, onerous identification requirements remain for children who are being raised by relatives outside the child welfare system. Documents may be difficult to access, and in some states, relatives do not have automatic permission to obtain copies of identification papers. Even when relatives are able to request copies, the process can be time-consuming and relatively expensive. Safeguarding access to Medicaid for those most in need should be a priority. The Elementary and Secondary Education Act, overdue for reauthorization, could provide a valuable opportunity to recognize the needs of children being raised in grandfamilies. Reauthorization should

emphasize the elimination of barriers that inhibit grandparents and other relative caregivers from promptly enrolling children in school and participating in important aspects of the child’s development, such as meeting on Individual Education Plans (IEPs), or in the case of young children served by Part C, Individual Family Service Plans (IFSPs), that typically involve parents. Reauthorizations of Head Start/Early Head Start and ESEA (where Title I funds can also be used to support early childhood services) should also focus on ensuring grandparents and other relative caregivers caring for very young children have access to services that support the development and early learning of infants and toddlers. Furthermore, the reauthorization should focus on collaboration as appropriate between grandfamilies and local education agencies, schools, school districts, and community providers to help reduce and mitigate barriers to access educational services. The Fostering Connections Act begins the process of ensuring educational access and stability by requiring states to provide assurances in their Title IV-E state plans that every school–age child in foster care and every school–age child receiving an adoption assistance or guardianship assistance payment is enrolled as a full-time elementary or secondary school student or has completed secondary school. In addition, the Child and Family Services Improvement and Innovation Act of 2011 requires states to describe in their child welfare plans how they are meeting the developmental needs of young children. States should consider the needs of grandfamilies in using these assessments to improve children’s access to developmental services.

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The Elementary and Secondary Education Act, overdue for reauthorization, could provide a valuable opportunity to recognize the needs of children being raised in grandfamilies.

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Respite Care Recommendation • Expand and improve respite care services for grandparent and other relative caregivers outside of the foster care system. Respite care -- or the temporary relief for family caregivers who are caring for those with disabilities, chronic or terminal illnesses, of any age -- can improve family functioning, improve satisfaction with life, enhance the capacity to cope with stress, and improve attitudes toward the family member with a 12 disability. Planned or emergency respite services can provide relative caregivers with time to deal with their own personal health, a financial or housing crisis, or to take a break from daily caregiving, which can be especially detrimental to an older caregiver’s 13 health and well-being. Respite programs can occur in a variety of settings, including the families’ homes, providers’ homes, camps, residential facilities, child care centers, recreational facilities, churches, therapeutic child development centers, family resource centers, schools, and senior centers. They are often administered by public or private welfare agencies, mental health agencies, religious institutions, family resource centers, child care centers, aging service providers or a combination. The Lifespan Respite Care Program enables states to establish, enhance or expand Lifespan Respite Care systems, including providing planned and emergency respite services, training and recruitment of respite workers and volunteers, and assisting caregivers with gaining access to needed respite services. The U.S. Administration on Aging (AoA)recently has funded six new states to establish Lifespan Respite systems, bringing the total up to 30 states now in the program. AoA-funded projects propose to serve all eligible family caregivers, including family members, foster parents, or other

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adults providing unpaid care to children and adults of all ages with special needs. Grandparents raising grandchildren are specifically targeted for assistance. A list of grantees and their contact information is available at www.aoa.gov. Legislation to reauthorize the Lifespan Respite Care Program was introduced in the House of Representatives in 2011, but no further action has been taken. Generations United strongly supports reauthorization and full funding of this important federal program.

Other Family Caregiving Family caregivers maintain and coordinate care at home for relatives who are elderly, disabled, and chronically or terminally ill. Over 29 million family caregivers provide care for adults (18 year and older) with disabilities or chronic illnesses, with many caregivers holding jobs 14 at the same time. About 12.9 million people in the U.S. care for both an adult(s) and 15 child(ren). More than three in ten U.S. households (31.2 percent) report that at least one person has served as an unpaid family caregiver within the last twelve months, leading to an estimate of 36.5 million 16 households with a caregiver present. If replaced with paid services, it is thought that the economic value of informal caregiving 17 would approximate $257 billion. Informal caregiving will likely continue to be the largest source of long-term care service in 18 the U.S. for years to come. Though many caregivers feel positive about providing care and appreciated by care recipients, they are more likely to suffer from depression and other mental health problems than people who are not providing such 19 care. Those who care for people with dementia experience even higher levels of 20 depression. Employed caregivers often have to make problematic and burdensome accommodations by working fewer hours,


rearranging schedules, taking time off without pay, or quitting work altogether to 21 become full-time caregivers.

The National Family Caregiver Support Program (NFCSP) Recommendations • Include provisions in the Reauthorization of the Older Americans Act that encourage states to use their allowable 10 percent of National Family Caregiver Support Program funding to serve grandparents and other relatives raising children. • Ensure that states collect, maintain and report clear data on their use of the allowable NFCSP funds. • Increase funding for and implement the expansion of the National Family Caregiver Support Program included in the Older Americans Act Amendments of 2006 and any changes that may be included in the next reauthorization. The NFCSP, originally enacted in 2000, funds supportive services to family caregivers providing care to older relatives or relatives with severe disabilities and – at state option -- ten percent of funds for the program are available for supportive services to grandparents and other relatives who are over 55 and raising children. Some states use the full 10 percent to serve these families. Some states use none of their funds or only a small portion of the allotted amount for this purpose. As a result, many grandfamilies are left without access to important supportive services that could be provided through their local Area Agency on Aging or partnering organization. In 2006, Congress reauthorized the National Family Caregiver Support Program - as part of the Older Americans Act – and made changes to allow more grandparents and other relatives raising children and older adults caring for adult relatives with

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disabilities to receive assistance. The funding, however, did not increase proportionally to include this expanded group of eligible recipients. Increased funding is needed as are regulations and guidance to help maximize the effectiveness of this important program. NFCSP authorized $125 million in its first year and has slowly increased to $187 million in 2011. Acknowledging the success of the NFCSP, the President’s FY 2011 budget, and the resulting Senate and House appropriations bills, included a significant boost of 31 percent to the NFCSP as part of “The Caregiver Initiative” recommended by the Vice President’s Middle-Class Task Force. The corresponding Older Americans Act program for caregivers in Indian country (Title VI C) received an identical 31 percent increase recommendation. The reauthorization of the National Family Caregiver Support Program presents an opportunity to encourage more states to serve grandfamilies with these dollars.

Child Care Recommendation • Ensure ongoing increases to child care funding to maintain and expand access and high quality for eligible families such as grandfamilies; who face unique challenges in accessing affordable child care. The U.S. Census Bureau reports that almost 70 percent of families rely on regular 22 child care arrangements. Child care not only keeps families working, but research shows that high-quality early childhood programs help children, especially those from families with low incomes, develop the 23 skills they need to succeed in school. These low-income families include a substantial portion of grandparent- and other relativeheaded families. In 2009 and 2010, the American Recovery and Reinvestment Act allocated additional child care funding to

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National, state, and district-by-


states, including set asides for quality improvement and quality care for infants and toddlers. This increase helped states maintain and expand access to child care. Congress should work to make these increases, and the child care spots they provide, permanent. Maintained and expanded access and quality is critical to provide work and early learning solutions for the over two-thirds of eligible families who do not receive subsidies and to increase the 24 supply of quality programs. More information about Child Care is available in the Social Supports section of this agenda.

district data on the number of children in relative care are vital to identify and demonstrate the need for ongoing supports for grandfamilies.

Data Collection Recommendation • Improve the U.S. Census Bureau’s collection of data on children in relative care and grandparents raising grandchildren and expand data collection to include information on aunts, uncles and other nonparent relatives raising children. National, state, and district-by-district data on the number of children in relative care are vital to identify and demonstrate the need for ongoing supports for grandfamilies. The U.S. Census Bureau collects information about the number of children in relative care and some demographic and social characteristic data on grandparents raising grandchildren through the annual American Community Survey. More data on grandfamilies are needed, including information on the numbers and characteristics of other relatives raising children.

Immigration Recommendation • Ensure that any immigration reform proposals preserve families and allows them to engage fully in community life and access support services as needed. About 18.4 million children are part of an 25 immigrant family. Families from various

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cultures rely on alternate family structures to preserve their traditional way of living. In many families, multigenerational households are the norm and a source of strength. Even without a cultural preference, recent immigrants may prefer multigenerational households to share resources and embrace their relationships as a measure of consistency. These diverse family forms create opportunity for family members across the generations to learn from and help each other. Despite these assets, immigrant families can face the challenge of mixed documentation status households. With one or more undocumented member, everyday caregiving activities can seem risky, causing families to retreat from civic spaces. A climate of stigma that may deter involvement in a child’s education or reporting crimes like domestic violence results in a misplaced burden on children and a dangerous lack of victim protection. In addition, without consistent partnership across the levels of government, state and local governments shoulder the cost of support services that undocumented family members need. Immigration enforcement that leads to the detainment and deportation of caregivers presents a serious danger to children. The trauma of witnessing enforcement activities is compounded by the experience of separation. This can be followed by inconsistent practices of determining caregiver and child relationships and denying reunification activities. Furthermore, undocumented family members can be reluctant to make known that they are available to provide the continuity of care a child needs when they come to the attention of the child welfare system. Absent comprehensive immigration reform, legislation must address better coordination between Homeland Security and all relevant agencies, including a process for ensuring coordination of care for children of detained and deported caregivers.


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Social Supports Issues and Recommendations

Intergenerational Intersection enerations United supports federal

G

involvement in programs that recognize

younger and older people as resources for their communities. These social support programs should provide opportunities for younger and older generations to interact and serve one another in paid, stipended, and volunteer positions.

Position Statement Generations United’s mission demands an active voice before Congress and the Administration on social programs that best support the multigenerational needs of families and communities. The federal government, in partnership with state and local governments and thousands of nonprofit organizations across the country, has long directed resources to important social programs that support citizens of all ages. While increased flexibility and responsibility have been given to state governments for the use of federal funds in domestic programs, such flexibility should not compromise the access to or quality of services and should be tied to improved outcomes for the people they are supposed to help. Generations United is committed to advocating for continued federal involvement in effective social programs that protect and support people in need, from the very youngest and most vulnerable to the oldest and frailest of our nation’s people. We believe a healthy society can and should meet the basic needs of all generations and make investments in their wellbeing in times of economic hardship and prosperity.

Older Americans Act (OAA) Recommendations • Reauthorize the Older Americans Act to strengthen multigenerational civic engagement programs, promote opportunities for intergenerational programs and shared sites, and encourage states to use National Family Caregiver Support Program funds to serve grandfamilies. The Older Americans Act (OAA) funds critical programs and services to keep older adults independent, including home delivered and congregate meals, home and community-based care, transportation, senior centers, family caregiver support, prevention of elder abuse, and older worker training and employment. Without these home and community-based services, many older adults would end up requiring much more expensive institutional care or suffer unnecessarily from hunger, isolation, ill health, neglect, abuse, unemployment or other challenges to living healthfully and independently. A number of intergenerational program opportunities exist within OAA to encourage young and old to share their talents and resources and support each other in relationships that benefit both the individual and the whole community. The Aging Network, which is funded under OAA, should be encouraged to seek out these intergenerational opportunities, including creating shared site for aging programs or maximizing the intergenerational potential in volunteer and community service programs. One challenge is the lack of funding for planning staff at the Area Agency on Aging (AAA) level. Most AAAs do not have dedicated planners able to lead their community in preparing for the aging of the

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Photo by Pedro Centeno.

"And in the end it's not the years in your life that count. It's the life in your years."

Abraham Lincoln

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Baby Boomers or seek out the special partnerships required to pursue the cohousing of invaluable community programs in a shared site model. The Multigenerational and Civic Engagement Program added to the OAA in the 2006 reauthorization, funds projects that provide support for grandparents and other older individuals who care for children, enlist volunteers to help families of disabled children, and other efforts to coordinate multigenerational civic engagement activities. The program should be transitioned from a demonstration to a permanent national program in this reauthorization and be positioned to disseminate the findings from the demonstration research to strengthen and implement multigenerational civic engagement approaches nationwide. Annual appropriations should reflect the importance of these programs to the individuals receiving support and to society as a whole. These appropriations should also support the unfinished work from the demonstration that calls for the Assistant Secretary for Aging to develop a comprehensive strategy for involving older individuals in efforts to address critical local needs of national concern.

Demonstration projects, such as those included in the OAA, provide an opportunity for innovative programs that recognize seniors as resources to their communities. Successful programs such as Experience Corps and Family Friends emerged as demonstration projects. Experience Corps builds on the capacities of older adults and engages them in leadership to strengthen ties between the schools, youth serving organizations, and communities. Family Friends is an intergenerational family support program involving volunteers 55 years and older who make weekly visits to the homes of families who have children with disabilities and chronic illnesses. The National Family Caregiver Support Program (NFCSP) is an Older Americans Act program that funds supportive services to family caregivers providing care to older relatives or relatives with severe disabilities and—at state option—ten percent of funds for the program are available for supportive services to grandparents and other relatives who are over 55 and raising children. For more information about the NFCSP, see the above Grandfamilies and Other Family Caregiver section of this agenda, and visit www.gu.org.

Corporation for National and Community Service Recommendations • Increase funding for the Edward M. Kennedy Serve America Act to the level of 250,000 members, as embodied in the law. • Complete implementation of the Silver Scholarship provision of the Edward M. Kennedy Serve America Act. • Broaden eligibility in the regulations for an AmeriCorps member or Silver Scholarship recipient to transfer his or her education award to anyone, rather than limiting this transfer to a child, grandchild or foster child.

Social Supports

The Corporation for National and Community Service (the Corporation) administers programs that tap the experience and skills of older and younger people to help others through structured volunteer and stipend service. The Edward M. Kennedy Serve America Act of 2009 reauthorized the Corporation, providing for dramatic growth and improvements, particularly of the AmeriCorps program. These are the programs that offer multigenerational benefits: AmeriCorps is authorized for 250,000 stipended positions, an increase of over 75,000. AmeriCorps establishes five focal areas, all of which aim to benefit multiple age groups, and all AmeriCorps programs require strong, measurable outcomes. The Serve America Act requires that 10 percent of state and national grants be targeted to programs that engage substantial numbers of members age 55 and older, including in multigenerational teams. Several new incentives are especially attractive for members who are age 55 or older: the ability of part-time members to serve up to four terms, rather than two, and the provision allowing members to transfer an education award to a child, grandchild or foster child. Unfortunately, legal restrictions prevent volunteers from transferring the award to a child or youth who they volunteer with or mentor. Senior Corps is a collection of programs that engage approximately 400,000 older Americans in service to their communities as volunteers or in exchange for small stipends. Two of the programs serve children and youth: Foster Grandparent Program – Foster Grandparents serve children in need through locally managed programs that place and monitor volunteers in schools, child care agencies, health care programs, and other local agencies. Members must be age 55 or older and have incomes below 200 percent of the poverty level.

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Retired Senior Volunteer Program (RSVP) RSVP volunteers provide a wide variety of community supports to people of all ages. Members must be age 55 or older. Silver Scholarships were authorized in 2009. An education grant of $1,000 may be provided to people age 55 and older who volunteer a minimum of 350 hours annually. They may transfer the award to a college fund for a child, foster child or grandchild. Unfortunately, this program has not yet been funded.

Social Services Block Grant Recommendations • Maintain funding of at least $1.7 billion and allow states to transfer 10 percent of their Temporary Assistance for Needy Families (TANF) block grant.

Social Services Block Grant provides critical, flexible funding for important social services for people of all ages, including adult and child day care, adult and child protective services, special

• Oppose efforts to reduce the federal deficit by eliminating the SSBG, which provides critical services for grandfamilies.

services for

The Social Services Block Grant (SSBG), Title XX of the Social Security Act, enacted in 1975, was intended to be the primary source of federal funds for social services. SSBG provides critical, flexible funding for important social services for people of all ages, including adult and child day care, adult and child protective services, special services for people with disabilities, meal programs, employment preparation, and transportation. Administered by HHS, SSBG is used by states, local governments, and nonprofit organizations to address unique community needs by supplementing social service programs and leveraging additional funding and resources. In 2009, SSBG assisted almost 22 million individuals, 49 percent of whom were children. Additionally, almost 1.7 million adults age 60 and older received services funded, in whole 26 or in part, by SSBG.

programs,

people with disabilities, meal

employment preparation, and transportation.

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Service providers rely on SSBG as a vital source of funding to fill gaps in services beyond what is supported by other federal, state and local funds, or to pay for activities that are either not authorized by the federal government (like “meals on wheels” and medical transportation for elderly and disabled individuals) or underfunded by other programs. Those gaps in funds are likely to increase as federal funds in other programs are reduced. As SSBG funding has steadily deteriorated, states have been forced to roll back critical human services. States are now expected to cut key human services programs even further to address significant budget shortfalls. Although economic conditions are improving homelessness and unemployment remain problems, and the need for these human services intensifies. In May 2012, the House of Representatives passed a Budget Reconciliation bill, the Sequester Replacement Reconciliation Act of 2012. This legislation calls for the repeal of SSBG as one of many strategies to address the federal debt. Generations United supports maintaining funding at $1.7 billion, in addition to allowing states to transfer 10 percent of their Temporary Assistance for Needy Families block grant to SSBG, without amendments to the annual appropriations language, as originally stated in the Personal Responsibility and Work Opportunity Reconciliation Act of 1996. Any efforts to repeal the Social Services Block Grant, especially in these times of economic recovery, should be opposed.

Child Welfare Services Recommendations • Enact comprehensive child welfare reform to ensure the permanency, safety, and wellbeing of children who come to the attention of the child welfare agency by expanding

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and improving federal support for preventative, specialized treatment, and postpermanency services before children enter foster care, while in care, or when they are returned home, placed permanently with relatives, or adopted. Title IV-E of the Social Security Act, which provides for foster care maintenance payments, adoption assistance payments, and at the option of the state, guardianship assistance payments, is the major source of federal support for child welfare. Other federal funds that support child welfare include the Social Services Block Grant, Medicaid, and TANF. States supplement these federal funds with state funds to implement activities such as prevention and supportive services for children who are not eligible for federal assistance. Title IV-E provides federal reimbursement for some of the foster care, guardianship, and adoption expenses states have already paid. It is an individual entitlement with no cap on federal funding. Reimbursement is provided for the roomand-board costs associated with foster care placements, guardianship, and adoption assistance; administrative costs that support caseworker planning and some services; and training for the child welfare workforce. Federal funding for out-of-home care (foster care, guardianship, and adoption assistance) was $7.161 billion in FY 2010. To move forward with a new vision and course of action that ensures the permanency, safety, and well-being of all children who come to the attention of the child welfare system, states and communitybased agencies need to have tools and resources in place to make certain children and their families’ needs are met. Generations United supports comprehensive reform of the child welfare system to ensure states and community-based agencies that serve children and their families have the

Social Supports

flexibility and new federal financial investments to implement needed improvements and expand services. Comprehensive reform must include expanding and improving federal support for preventive, specialized treatment, and postpermanency services before children enter foster care, while in care, or when they are returned home, placed permanently with relatives or adopted. See the Supports for Grandfamilies and Other Family Caregiving section for further discussion. The Fostering Connections Act was signed into law on October 7, 2008, and constitutes a first step towards educating the child welfare workforce, and making improvements in accountability.

Elder Justice Recommendations • Secure initial investments in the Elder Justice Act and passage of additional legislation to ensure that older adults have comprehensive national protections from abuse and fraud. • Support first-year funding of at least $21.5 million for the Elder Justice Act, and enact additional legislation to provide comprehensive elder justice in this country: the Elder Abuse Victims Act, the National Silver Alert Act, the Senior Financial Empowerment Act and the Robert Matava Exploitation Protection for Elder Adults Act of 2012. Elder abuse is a growing problem in this country and yet is too often invisible, misunderstood or ignored, in part because prevention and enforcement efforts are under-funded. More than one in ten older adults may experience some type of abuse, but only one in five cases are estimated to be 27 reported. The annual financial loss, which by law includes several provisions sought by victims of elder financial abuse, is reported to 28 be at least $2.6 billion. Generally, elder

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abuse falls within three basic categories: domestic, institutional, and self-neglect. Within this framework, elder abuse can be physical, sexual or psychological, neglect by one’s self or other caretakers, abandonment, and financial exploitation. The aging of the Baby Boomers, along with an increase in rates of Alzheimer’s disease and resulting strains on professional and family caregivers alike, will only exacerbate the problem of elder abuse. Federal response to this urgent national issue has been lacking and state definitions of the problem and resources dedicated to solutions vary widely. Elder abuse prevention and enforcement systems are estimated to be decades behind comparable systems for the prevention of child abuse and domestic violence. The enactment of the Elder Justice Act in 2010 provided the first national response to this crisis, authorizing investments in nationwide community-based prevention, reporting systems, research, and training to combat elder abuse. Provisions of Elder Justice Act include the authorization of $400 million over four years to fund Adult Protective Services; the authorization of $32.5 million over four years to support the Long-Term Care Ombudsman Program; the authorization of funding for demonstration grants to improve Adult Protective Services and provide additional ombudsman training; and the establishment of an Elder Justice Coordinating Council to make recommendations to the Secretary of HHS on the coordination of activities of federal, state, local, and private agencies and entities relating to elder abuse, neglect, and exploitation. Passed along with the Elder Justice Act, the Patient Safety and Abuse Prevention Act created a national program of criminal background checks for persons seeking employment in nursing homes and other long-term care facilities-- yet another

Elder abuse is a growing problem in this country and yet is too often invisible, misunderstood or ignored, in part because prevention and enforcement efforts are under-funded.

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Federal nutrition programs are critical supports for children, youth, and older adults. They reduce poverty, prevent obesity, improve education and achievement, and boost health.


important way to prevent elder abuse. Unfortunately, the Elder Justice Act and the Patient Safety Abuse Prevention Act have not yet been funded, and these new protections and systems enhancements cannot be implemented without sufficient appropriations. An appropriation of at least $195 million is needed to fully implement the Elder Justice Act, but first-time funding of at least $21.5 million should be immediately provided. Additional legislation to provide comprehensive elder justice should also be considered: the Elder Abuse Victims Act, the National Silver Alert Act, the Senior Financial Empowerment Act, and Robert Matava Exploitation Protection for Elder Adults Act of 2012.

Nutrition Programs Recommendations • Protect, strengthen and expand proven hunger and nutrition programs such as the Supplemental Nutrition Assistance Program, and promote innovative intergenerational approaches to meeting hunger needs such as those in shared sites where children and seniors interact and share resources. Federal nutrition programs are critical supports for children, youth, and older adults. They reduce poverty, prevent obesity, improve education and achievement, and boost health. Generations United supports cost-effective public interventions that are important to all generations. Many working parents and relative caregivers rely on community nutrition resources to help provide adequate nourishment for their children in early care and education programs, and before- and after-school hours. Federal support for these programs is particularly important, as many families continue to struggle to meet basic needs. Information about nutrition assistance

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programs, including the Supplemental Nutrition Assistance Program (SNAP)— formerly known as the Food Stamp Program—can be found below in the Income Supports section of this agenda.

Child and Adult Care Food Program (CACFP) CACFP is a federal nutrition program that provides reimbursements for meals served to low-income children in before- and after-school programs, child care centers, Head Start and Early Head Start programs, family child-care homes, and to adults attending adult day care centers. The CACFP supports the nutrition and health of more than 3.2 million infants and children and more than 112,000 impaired or older adults, primarily from low-income 29 households. CACFP meals give children and adults the nutrition they need as a routine part of their day-care program. CACFP reimbursements help to lower the cost of serving meals at centers that provide day care services to meet the needs of developing children and impaired adults. However, both child and adult day care centers under-utilize the CACFP program because complex regulations limit access. The current low reimbursement rates fall short of covering rising food and fuel costs and do not offset the administrative burden imposes. Increasing subsidies and limiting administrative and paperwork requirements should be complemented by streamlining nutrition standards across age groups. Appropriate nutrition standards that are inclusive will enable and encourage sharedsites to serve needed meals to more people, more efficiently.

Supplemental Nutrition Program for Women, Infants, and Children (WIC) The WIC program provides nutritious foods, nutrition education, and referrals for

Social Supports

health care and social services to lowincome pregnant, postpartum, and breastfeeding women, as well as infants and children up to age five who are at nutritional risk. However, it is essential that the WIC program have continued capacity to meet ever-growing needs and expand access to newly-eligible women and children. Adjusting regulations governing categorical eligibility, application procedures, and program and paperwork requirements can increase access to both the CACFP and WIC programs. Additionally, food packages and benefits provided by both these programs should be regularly updated to reflect current nutrition science and fully funded to ensure benefits adequately cover the cost of a healthy diet.

Nutrition Supports for Older Adults Over three million older Americans participate in senior meal programs each year under the Older Americans Act, Title III C. Meals are provided to individuals who need them most. Seventy-three percent of home-delivered meal recipients are at high nutritional risk and 62 percent of them receive half or more of their daily food intake 30 from their home-delivered meal. In addition to seniors participating in nutrition services under the Older Americans Act, an estimated four million more older Americans suffer from food insecurity or the 31 inability to afford, prepare, or acquire food. Good nutrition is essential to maintain cognitive and physical functions and plays a crucial role in the prevention or management of many chronic conditions such as heart disease, cancer, stroke, diabetes, and osteoporosis. Providing nutrition services to ethnic minority older adults is especially important since they tend to have higher incidences of chronic disease. Recent price increases for food and fuel have further compounded years where funding levels have not kept pace with inflation or the

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growing aging population. These factors leave programs struggling to meet the needs of current elders, even as rising numbers of new clients seek assistance. Additional resources should be directed to senior nutrition programs to meet the increasing demand for congregate and home-delivered meals because of the growth of the age 85 and older population, which is expected to double from 3 million in 1990 to 32 7 million by 2020. It is also important to acknowledge that while the main goal of the Older Americans Act nutrition program is to feed older people in need, it also plays an invaluable role in giving participating seniors opportunities to socialize and remain engaged in their community and preventing isolation. Research shows that intergenerational programs are particularly effective at addressing social isolation issues 33 among older adults.

Education Recommendations • Encourage and support engagement of community members of all ages in schools through reauthorization of the Elementary and Secondary Education Act.

Seventy-three percent of home-delivered meal recipients are at high nutritional risk and 62 percent of them receive half or more of their daily food intake from their home-delivered meal.

• Support federal funding and incentives for states to invest in high quality early childhood education for children ages birth to five, including child care, Early Head Start, Head Start, and pre-K. • Support substantial and sustained funding increases for Head Start/Early Head Start and the Child Care and Development Block Grant to ensure that children currently being served will continue to have access to high-quality program services, and to expand access and improve quality of these program services. • Ensure that language is included in the reauthorization of the Elementary and Secondary Education Act that promotes

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Photo by Jeanette DeVore

Early investments in education benefit all generations, provide substantial short-term returns to citizens, and build a more competitive future

wraparound supports, intergenerational collaboration, and that facilitates the transition of more schools into intergenerational shared sites. Early investments in education benefit all generations, provide substantial short-term returns to citizens, and build a more competitive future workforce. High quality early childhood education services for children ages birth to five, provided through such avenues as child care, Early Head Start, and state and private pre-K promote success in school and in life. These early education programs offer unique opportunities for older adult volunteers to assist program directors and provide additional one-on-one attention to children.

workforce.

Head Start and Early Head Start Head Start is a child development and early education program that has served atrisk preschool-aged children and their families since 1965. Head Start approaches the needs of the child and the family by providing health, education, social services, and parent-community involvement in one comprehensive program. The program’s clear emphasis on family and community involvement has intergenerational

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implications. Parents and caregivers are active in the planning and implementation of activities, serve on policy councils and committees that make administrative decisions, participate in classes and workshops on child development, and volunteer in the program. Recognizing that disparities in children’s cognitive and social-emotional development become evident well before they enter Head Start or pre-kindergarten programs, the federal government expanded the Head Start program in 1994 to include Early Head Start, a comprehensive early childhood program that serves at-risk children prenatal to age three, pregnant women, and their families. Early Head Start’s mission is clear: to support healthy prenatal outcomes and enhance the cognitive, social, and emotional development of infants and toddlers in order to promote later success in school and life. During the 2009-2010 program year, Early Head Start served 133,217 pregnant women 34 and children. Despite its growth, current funding for Head Start can assist less than half of all eligible young children while Early Head Start reaches only four percent of all eligible 35 infants and toddlers. Significant funding increases are necessary in order to maintain, strengthen, and expand these high-quality programs as well as institute new initiatives and training mandated by the reauthorization of Head Start and Early Head Start in 2007. Head Start, Early Head Start, and other early childhood programs offer unique opportunities for older adult volunteers to assist program directors and provide additional one-on-one attention to children. While the Recovery Act directed temporary funding to expand Head Start and Early Head Start, substantial and sustained increases in federal funding are required for these programs to reach their full potential and ensure that hundreds of thousands of

Social Supports

children do not lose access to these services. It is vital that political and financial support are provided for improving quality and expanding access to early childhood and education.

Other Early Childhood Programs As decades of rigorous research proves, investing in high-quality, voluntary prekindergarten nets short- and long-term 36 returns for taxpayers. Children who have the opportunity to participate in quality early education and pre-K programs have better educational outcomes, graduate in higher numbers from high school, have a reduced incidence of problems later in life, and enjoy 37 significantly greater lifetime income. Every dollar invested in quality pre-k can save taxpayers up to $7 over time in higher earnings, tax revenues, crime control, and 38 reduced costs. Economist James Heckman cites a return on investment that increases over time, with an annual return of 10 percent over the life of a child for every dollar 39 invested in early childhood education. Some of the intergenerational benefits of quality early childhood programs include providing families the opportunity to work and maintain stable jobs, and providing children learning opportunities during a critical stage in their development. Some of the benefits of these programs, when discussing the federal budget, include minimizing the number of children needing special education, reducing crime and delinquency, and producing a more competitive workforce. Like Head Start and Early Head Start, demand for child care services still far outstrips the availability of programs that meet high- quality standards and provide services for different work schedules of families. Across the nation, child care fees average $4,000 to $15,000 per year, making it increasingly difficult for low-income families 40 to access high- quality programs. The Child

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Care and Development Block Grant (CCDBG) is helping to promote access to child care for low-income working families, yet only one in six children eligible for child care subsidies through CCDBG receive 41 them. The U.S. Census Bureau reports that almost 70 percent of families rely on regular 42 child care arrangements. Child care not only keeps families working, but research shows that high-quality early childhood programs help children, especially those from families with low incomes, develop the 43 skills they need to succeed in school. These low-income families include a substantial portion of grandparent- and other relative-headed families. In 2009 and 2010, the American Recovery and Reinvestment Act allocated additional child care funding to states, including setasides for quality improvement and quality care for infants and toddlers. This increase helped states 44 maintain and expand access to child care. Congress should work to make these increases, and the child care spots they provide, permanent. Maintained and expanded access and quality is critical to provide work and early learning solutions for the over two-thirds of eligible families who do not receive subsidies and to increase the 45 supply of quality programs.

Elementary and Secondary Education Act (ESEA) In 1965, President Johnson signed the Elementary and Secondary Education Act (ESEA) into law to ensure equal access to education and to establish accountability standards through federally funded education programs administered by states. In 2002, Congress amended ESEA and reauthorized it as the No Child Left Behind Act. In the 113th Congress, ESEA may be renewed and should focus on the extension of high quality learning experiences, with greater

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emphasis on integration of early childhood and K-12 services. Decades of rigorous research demonstrate that quality early education programs benefit children academically and socially well into 46 adulthood. They also strengthen communities over time by building a more competitive future workforce and contributing to long-term savings. Recent education reform has focused on making dramatic improvements to the lowest performing schools. The reauthorization of ESEA can play an important role in institutionalizing practices that will improve outcomes for students nationwide, especially for low-income students in Title I disadvantaged schools. By promoting the engagement of older adults as teachers, staff, and well-trained volunteers for Title I schools, a reformed Elementary and Secondary Education Act can institutionalize a fresh and sensible approach to reversing the declining educational standards and services in America. Research shows that intensive engagement by older adult volunteers in schools improves their own physical and 47 cognitive health. Youth also benefit with improved reading scores and fewer behavioral 48 problems. Indeed, incorporating intergenerational strategies in education reform has the potential to transform schools that serve students who need substantial support to be successful in readying their students for college and a career. Opportunities for increasing intergenerational services and impacts within schools can be accomplished through proposed and potential legislation under the banner of “community engagement in schools.” Our nation’s schools are uniquely positioned to become intergenerational shared sites and engage older adults as resources for the education of our youth. By delivering services to children, youth, and older adults under one roof, communities can save

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precious resources while also investing in people of all ages. Congress should consider language throughout U.S. Department of Education programs that will ensure that schools, school districts, and teachers are involving their surrounding communities and community partners, including older adults seeking significant “encore” roles. Programs such as “Troops to Teachers” and other streamlined teacher certification programs can expedite this process, putting the wealth of experience and knowledge of older Americans to work in the classroom. Other local interventions, such as Experience Corps, use older adults as tutors and mentors to young students. The presence of community coordinators within schools, provided for in programs such as Promise Neighborhoods, 21st Century Community Learning Centers, and Full Service Community Schools, would help to effectively manage needed community services within low-performing schools. These coordinators can also facilitate the appropriate sharing of data between schools and their community partners to ensure both accountability and shared success. The grants authorized in the DIPLOMA Act would incentivize partnerships between schools, parents, business leaders, higher education institutions, and community‐based organizations. Additionally, the proposed Families and Communities Involved in Improving Our Schools Act would require Local Education Agencies receiving school improvement funds to involve community members in their improvement strategies and would direct the U.S. Secretary of Education to detail evidence-based family and community engagement strategies that can be supported with school improvement funds.

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Livable Communities Intergenerational Intersection enerations United recognizes that liv-

G

ability is a key issue of concern across

generations. Younger and older populations and their caregivers have a particular need for safe and accessible environments, transportation, and housing. They are particularly reliant on public transit and public services, such as libraries and community centers. They are especially vulnerable to crime, including abuse and neglect, gun and other violent crime. At the same time, effective intergenerational policy recognizes that children, youth, and seniors can be resources to each other to help promote safe, accessible, livable homes and communities.

Position Statement Generations United is committed to creating truly livable communities. These are strong neighborhoods, villages, towns, and cities – urban and rural – where people are not separated by age, race or economic status. The best communities offer a range of choices in transportation and housing that are accessible and affordable to people with diverse needs. A livable community should also possess conditions and technologies that make work possible for all that are able.

Issues and Recommendations Housing Recommendation • Fully fund the National Housing Trust Fund. The National Housing Trust Fund (NHTF) was created in the Housing and Economic Recovery Act of 2008 (HERA) to address the severe shortage of rental homes that are affordable for the lowest income families, but it

has not yet been funded. According to the National Low Income Housing Coalition, there are only 37 rental homes available and affordable for every 100 households with incomes below 30 percent of their area median. A scarcity of housing that the poorest families can afford is the principal cause of homelessness in the United States. In addition to providing homes for those most in need, fully funding NHTF will also lead to job creation.

By delivering services to children, youth, and older adults

Shared Sites Recommendation

under one roof,

• Create policies and reform regulations to make it easier for facilities that wish to provide services to more than one generation to access funding streams.

save precious

communities can

resources while also investing in people of all

Intergenerational shared sites are programs in which people of different generations are engaged at the same site and interact through planned activities and informal interactions. By delivering services to children, youth, and older adults under one roof, communities can save precious resources while also investing in people of all ages. Research has shown shared sites have substantial benefits for children and older adults. Preschool children involved in intergenerational programs had higher personal/social developmental scores (by 11 months) than preschool children involved in 49 non-intergenerational programs. In schools where older adults were a regular fixture (volunteers working 15 hours per week), children had improved reading scores and fewer behavioral problems than their peers at 50 other schools. Older adults who regularly volunteered with children burned 20 percent more calories per week, were more optimistic, experienced fewer falls, were less reliant on canes, and performed better than peers on a 51 memory test.

ages. Research has shown shared sites have substantial benefits for children and older adults.

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Photo by Pedra R.

There are regulatory and financial barriers to the development of shared sites. Currently, many regulations and funding streams are designed with the idea that each facility and program serves a specific generation. Facilities that wish to provide services to more than one generation often have difficulty navigating or reconciling the myriad of regulations necessary to access funding streams. The Government Accountability Office should conduct a national study evaluating intergenerational shared sites and initiatives that provide opportunities to create and sustain these sites.

Sustainable Communities for All Ages Recommendation • Promote policies and regulations that guide and encourage community planning inclusive of the needs of all people including older adults, people with disabilities, and children. Since the 1960s, senior-only, “sun city” housing developments have been promoted as the Promised Land for new retirees seeking less responsibility and more relaxation. Changing demographics are leading some developers to re-think how they

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will plan for the communities they will develop over the next ten to twenty years and beyond. A 2002 survey of adults 50+ found that 59 percent see retirement as a time to be active and involved, to start new activities, and to set new goals; 56 percent say civic engagement will be at least a fairly important part of retirement; and that working with children was the most appealing volunteer activity among older-adults, with 35 percent seeing that as 52 most enjoyable. Furthermore, when looking toward retirement, Baby Boomers are considering not just their own housing needs but those of aging parents, cohabitating adult children, and grandchildren. In many families, multigenerational households are the norm and a source of strength. Certain families, such as those of recent immigrants can prefer multigenerational households to share resources and embrace their relationships as a measure of consistency. Policies and regulations that guide and encourage community planning inclusive of the needs of all people, including older adults, people with disabilities, and children, and reflective of shifting cultural demographics should be promulgated. There are myriad ways to ensure a community is a good place to grow up and grow old, but policymakers should carefully consider decisions that affect a community’s land use, housing and transportation; public safety; economic and workforce development; education, lifelong learning and recreation; as well as volunteerism and civic engagement.

Transportation & Mobility Recommendation • Promote transportation and community development policies that improve the mobility of people of all ages and abilities. Only one-half of Americans age 65 or older have access to public transportation to meet their daily needs. Compared with older

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Photo by Eder A.

drivers, older non-drivers in the United States make 15 percent fewer trips to the doctor, 59 percent fewer shopping trips and visits to restaurants, and 65 percent fewer trips for 53 social, family, and religious activities. Children also often rely on car rides to access daily activities like school and doctors’ appointments. Many public transit systems focus on commuters and reduce their services during the day when children and older adults are more likely to travel. In addition, a safe and accessible pedestrian environment benefits both younger children and older adults. For instance, a well-maintained system of sidewalks and walking paths coupled with well-designed crossing signals and signage help both the child walking to the school and the older adult interacting with their community stay safe and healthy. When considering any changes to transportation policy, it is vital to prioritize those programs that increase mobility for

people of all ages. With increased mobility for all, policymakers will have a prime opportunity to maximize shared resources. It is also critical that policies transform the community planning process so that all community resources are as accessible as possible and available to all.

Workforce Recommendation • Promote innovative ways for older adults to stay engaged in the workforce longer. The circumstances affecting workforce demand varies by sector, type of position, and the general economy, but workforce shortages exist now and are projected to worsen, particularly in health and education services. Providers clearly need to both retain current workers and attract “career switchers.” For many providers, this means accommodating the skills and needs of multiple generations. Nonprofit and public agencies should pay special attention to ensuring harmony in, and leveraging the multiple talents of, a shifting

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“It is an expression of faith, this yearning to give back, this hungering for a purpose larger than our own, that reveals itself not simply in places of worship, but in senior centers and shelters, schools and hospitals, and any place an American decides."

President Obama

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two- or three-generation workforce. Some approaches include: • Flexible scheduling (good for older workers who wish for less than full-time work, caregivers of aging parents, and parents of young children); • Phased retirement (to enable older workers to enter retirement gradually while still being available to pass along valuable institutional memory to younger colleagues); • Cafeteria benefit programs that allow individual workers to select the benefits that best fit their situation (for example, caregiving support for older workers with aging parents; sabbaticals for younger and mid-career workers; fitness programs and opportunities to volunteer for all ages); • Formal and informal mentoring programs that pair people at different stages in their careers in teams to tackle projects and foster mutual understanding; and • Sector strategies that retrain older workers, in combination with redesigning jobs as necessary, to meet local industry workforce demands in areas such as health care, community and social services, and education.

Technology Recommendation • Ensure that broadband technology is accessible to all communities and all ages. Technology has the unique ability to connect the generations. If technology is able to enhance the productivity and engagement of older generations, their lives will improve alongside the nation’s overall productivity level. Technology can also help tap older workers’ wealth of experience, to combine with and pass on to younger generations, further strengthening intergenerational linkages and exchanges. Young people can play a role in teaching/helping older adults to become familiar with new technologies, as well. And all ages benefit from online connections to family and friends that can reduce isolation, boost wellness and strengthen family bonds. But without affordable Internet access in all communities, this intergenerational potential may be lost. Generations United believes we must continue to invest in broadband technologies that allow Americans of all ages, including those who are low-income, access to the Internet and the wide range of public and private resources, services and information it delivers.

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Income Supports Intergenerational Intersection oday, nearly one in ten persons age 65 and over is poor and more than one in five children are

T

54

growing up in poverty . While most of our senior citizens have been able to maintain a dignified

standard of living thanks largely to intergenerational programs like Social Security and Medicare, we still have much work to do to reduce the near all-time high poverty rates among children in this country. This work is particularly urgent. Today’s children are expected to become productive members of society and provide the revenue upon

For more than

which our nation will rely in the future, but children who grow up in poverty are more likely than other

70 years, Social

children to have problems that affect their health, development, school-readiness and achievement, and

Security has

employability and productivity as adults. Raising the minimum wage and indexing it to average wages,

provided vital

modernizing the poverty measure, and investing in other income support programs will have long-term

benefits to millions of

benefits for children, families, and society as a whole.

Americans of all

For more than 70 years, Social Security has provided vital benefits to millions of Americans of all ages. Social Security is far more than a retirement program. Social Security pays more benefits to children

ages. Social Security is more than a

than any other federal program. More than 6.5 million children in the United States receive part of

retirement

their family income from Social Security through survivors, retirement, and disability benefits, as well as

program for

55

the Supplemental Security Income (SSI) program. Social Security embodies an intergenerational com-

older adults; it

pact. Contributions of the current generation of workers help finance the retirement of the current gen-

also provides

eration of beneficiaries. With the help of Social Security, along with Medicare, today’s seniors live longer,

benefits for

healthier lives than ever before and should be looked to as resources for their communities and country.

disabled

Social Security links the generations in a unique and fundamental way.

workers, their families, and

To ensure a healthy populace, several federal nutrition programs are vitally important to vulnerable chil-

millions of

dren, youth and older adults. In addition to school- and senior services- based nutrition programs, the

children.

56

Supplemental Nutrition Assistance Program helped feed approximately 45 million people in 2011, most of them children and older adults.

Position Statement Until the nation returns to economic health, we must do more to help low-income working parents increase their earnings while providing additional safety nets for them and their children. HHS should assist states in developing effective strategies to help move people into permanent, decent-paying jobs. These strategies need to deal with health, substance abuse, domestic violence, and

other barriers to work. These efforts must not just use reduced caseloads as simple, yet incomplete measures of progress, but should assist families and above all, improve the wellbeing of those families. Generations United recognizes the following important methods to help provide security: an increased minimum wage, an expanded unemployment program, a refundable Child Tax Credit, and the Earned

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Income Tax Credit. The Recovery Act contains temporary provisions that direct funding to several of these areas. While TANF caseloads have declined significantly since previous reforms, the number of families with special and intractable problems remaining on the rolls is increasing. Many states with severe budget shortfalls are in the reducing or eliminating services for lowincome families. In addition, job availability for low-skilled workers remains poor. States should be able to establish categories of specific hardships -- such as parents/caregivers with disabilities, people who care for those with disabilities or who face circumstances that make employment impossible -- which would warrant exemption from the time limit for families on TANF rolls. Generations United values Social Security’s role in providing vital support for retired or disabled workers and their families and for survivors of deceased workers. Social Security provides critical economic security during tough economic times, and cuts to the program would mean a considerable loss for children, families, and retirees. As the debate continues over how to achieve long-term solvency for the Social Security program, Generations United urges policymakers, advocates, and researchers to consider how reforms will affect vulnerable children, people with disabilities, spouses of deceased workers, retirees, and families as a whole. Congress should ensure the burden of reform is shared broadly across generations, especially by those who can most easily afford it.

Issues and Recommendations TANF Block Grant Reauthorization Recommendations • Increase funding for the Temporary Assistance for Needy Families (TANF) Block Grant.

Generations United

• Restore state flexibility to expand allowable work activities. The enactment of the 1996 Personal Responsibility and Work Opportunity Reconciliation Act (P.L. 104-193) (PRWORA) changed the welfare system in the United States. It ended the entitlement nature of public assistance to low-income families and replaced Aid to Families with Dependent Children (AFDC) with Temporary Assistance for Needy Families (TANF). TANF provides a block grant funding structure and gives states significant flexibility in developing their program. For this flexibility, states are required to meet specific work participation rates for families on assistance. Families must meet work requirements and face time limits on benefits. Since the passage of TANF, several unsuccessful attempts have been made to reform the program through the regular reauthorization process. During the passage of the Deficit Reduction Act of 2005, a number of policy changes were made to TANF that caused restrictions to the way states provide welfare benefits to groups of recipients. TANF funding has remained at the same $16 billion level since it was enacted in 1996. Furthermore, unlike the 1996 reauthorization, the Deficit Reduction Act provided almost no increase in child care mandatory funds. With the inevitable erosion of TANF funds and the strains placed on TANF funding as states struggle to balance their budgets, other vital human service programs will also be affected. Under the Fostering Connections Act, States have the option to use federal Title IVE funds to make guardianship assistance payments to eligible families, which will free up some of the TANF funds to be allocated in other much needed areas. These payments should be protected. The recent recession demonstrated

Income Supports

some of the challenges facing families who receive TANF, as well as those who have recently exited the TANF caseload. With escalating unemployment, many former TANF recipients with low skills are finding it difficult to find jobs. At the same time, the TANF programs in many states have not responded to the rising demand among lowincome families. TANF cash assistance programs have lagged far behind the Supplemental Nutrition Assistance Program (SNAP) in their responsiveness to the recession and rising poverty. Nationally, the total number of families with children receiving cash assistance has increased by just 10 percent since the beginning of the 57 recession. Compare this to a 37 percent 58 increase for SNAP. The reauthorization of TANF provides a platform to discuss and debate how best to address the barriers facing those still reliant on TANF, as well as those who have left assistance but whose economic struggles continue. The reauthorization should not focus primarily on work participation rates, without sufficient attention to the wellbeing of families and children still reliant on TANF cash assistance and the myriad human service programs dependent on TANF funding. Many challenges to remove or reduce barriers to successful and permanent employment among TANF recipients remain. Such barriers include, but are not limited to substance abuse, mental health issues, domestic violence, the presence of learning disabilities, and the range of needs of twoparent families on public assistance. How those barriers are—or are not—addressed will have a significant impact on the wellbeing of many families and the further success of the TANF program. Generations United urges Congress to reinforce the original principles of the TANF law and restore flexibility to achieve the following goals:

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• Welfare should continue to be viewed as a short-term, transitional experience - not a way of life. • Parents moving from welfare to work should receive the child care and health care they need to support and protect their children. • Child support programs should become more effective in securing support from absent parents while being sensitive to the challenges such efforts may present to grandfamilies. • Because many factors contribute to poverty and dependency, solutions to these problems cannot be one-size-fits-all. The system should allow states, Indian tribes, and localities to develop diverse and creative responses to their own problems. • The federal government should focus less attention on eligibility determinations and place more emphasis on program results. • States should continue to make substantial investments of state funds to address the needs of low-income families.

Child Support Recommendation • Provide incentives for states to pass through to children receiving TANF all or most of the child support collected on their behalf, instead of these funds being retained by the states. PRWORA requires states to strengthen their child support enforcement efforts and recover any public assistance dollars that were paid on behalf of a child from the parent who failed to support that child. This requirement has serious implications for grandparents and relative caregivers. A relative caregiver no longer chooses whether to pursue child support. If the relative seeks public benefits (TANF), the state must seek

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Social Security pays more benefits to children than any other federal program, protecting 98 percent of the children in the United States in the event they lose a parent.

Generations United


child support. Caregivers should be aware of this requirement before seeking benefits, because they may not want to set in motion a chain of events that could result in the incarceration of the child's parent or the loss of the parents’ professional license. Before enactment of the PRWORA, grandparents were exempt from cooperating with support enforcement efforts if they could establish that a parent presented a danger to either the grandparent or the grandchild. Federal law no longer defines a "good cause" refusal to cooperate. Each state defines "good cause" for itself and establishes its own strategies for pursuing child support. Relative caregivers who choose to apply for TANF or Medicaid must assign child support rights to the state. Such assignment means that the state can retain child support up to the amount the individual receives in TANF and Medicaid payments. PRWORA eliminated the state’s obligation to “pass through” even $50 of support a month to the child without reducing the family’s welfare payments. Thirty states have abandoned the pass-through. The Deficit Reduction Act of 2005 did a number of things affecting TANF: (1) gave states new flexibility to pass through more child support dollars to children who currently receive or previously received welfare, (2) imposed funding cuts on the child support enforcement program due to failed efforts to meet performance requirements, and (3) repealed the authority to use performance incentives as a match for federal dollars, as allowed by the Child Support Performance Incentive Act of 1998. That Act established an incentive program for good performance and required earned funds to be re-invested towards improving the program. This system has allowed the program to double collection rates over recent years. The Recovery Act provided a temporary

extension to the incentive match through September 30, 2010, but Congress has not taken further action since then. Generations United supports extending the incentive match authority, along with an examination of the impact of the Deficit Reduction Act on state TANF programs.

Social Security Recommendation • Protect and improve the adequacy of Social Security so it continues to meet its obligations to current and future beneficiaries, including the more than 30 percent who are under age 65 and receive disability and/or survivors’ benefits. Improve the Adequacy of Social Security by: • Reinstating the Student Benefit. • Improving Social Security’s support for grandfamilies and other nontraditional family structures by addressing barriers related to the family cap and grandchild benefit. • Providing Social Security credits to caregivers when their earnings are affected by caring for elders, children or individuals with disabilities. • Improving Supplemental Security Income (SSI) by eliminating the reduction in benefits for in-kind support and maintenance, increasing both SSI’s resource limit and income disregard. • Efforts to strengthen Social Security must not compromise our nation’s foremost social insurance program by carving out personal/individual accounts which would reduce benefits. Social Security is more than a retirement program for older adults; it also provides benefits for disabled workers, their families, and millions of children. In fact, Social Security pays more benefits to children than any other federal program, protecting 98

Income Supports

percent of the children in the United States in 59 the event they lose a parent. Social Security was founded on the belief that those who work long and hard should not become destitute due to retirement or disability, nor should their families suffer in the event of an early death. The program provides many essential protections for people of all ages: Disability Insurance – Social Security Disability Insurance provides income to individuals who work and pay Social Security taxes as well as many children under age 18 who receive Social Security benefits as dependents of insured workers who are retired, disabled or deceased. Benefits are also paid to children 18 or older who become disabled before age 22. Benefits continue into their adult years as long as they remain disabled. Social Security disability benefits protect more than 1.7 million dependents 60 (including more than a million children). Survivors’ Insurance – Survivors benefits provide monthly income support to a deceased worker's family. Children under the age of 18 (or up to 19 if they are attending elementary or secondary schools full time) and children 18 or older who become disabled before the age of 22 can receive survivors benefits on behalf of a deceased parent. As of December 2010, more than 6 million Americans were receiving survivors’ 61 benefits; of those, 1.9 million were children. A widow(er) caring for children under age 16 or who is disabled may receive benefits. In addition to children, survivors are often older adult women who have little earnings because they did not work outside the home or their careers were interrupted by caregiving responsibilities. Dependent Grandchildren – Nearly 7.8 million children across the country are living in households headed by grandparents or other relatives. For some children who are being raised by their grandparents, Social Security can be an indispensible financial support.

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Grandparents who raise grandchildren are at a significantly higher risk of poverty. These benefits allow many grandparents to raise their grandchildren, while providing an important degree of economic security. Supplemental Security Income (SSI) – The SSI program provides assistance to aged, blind, disabled people who have little or no income. The maximum federal SSI benefit is less than 75 percent of the poverty guideline for an individual and just over 80 percent for a couple. SSI’s support is indispensible to a family’s economic security. More than 7.5 million people received SSI benefits in 2008. SSI protects vulnerable children who otherwise may remain in poverty. In December 2008, nearly 1.2 million blind and disabled children younger than age 18 received SSI payments. SSI for Refugees --The 1996 welfare reform law limited SSI eligibility for refugees to seven years. In 2008, Congress passed legislation extending eligibility to nine years. This eligibility expired September 30th, 2010, for approximately 5,600 elderly and disabled refugees. Another 5,600 may lose their 62 eligibility within the next year. The Senate has since passed legislation to extend eligibility, but the House has not acted. Because SSI carries Medicaid eligibility, refugee health benefits are also vulnerable Naturalization is not an option for most of these individuals because of their age, disabilities, and limited educational background. Additionally they may be too poor to pay the citizenship fees. Generation United urges Congress to permanently extend refugee SSI eligibility from seven to nine years.

Minimum Wage Recommendation • Index the minimum wage to annual increases in median wages. Large portions of current welfare

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When many of the lowest-wage workers have not been in the workforce long enough to qualify for unemployment benefits when the economy falters, they find themselves forced back onto the TANF rolls.


recipients and former recipients who are now employed have family incomes either below 63 or at poverty level. Their opportunities to move up the occupational and economic ladder are constrained by limited education, job skills, and work experience. The phasedin increases in the minimum wage over the past few years have improved the situation for the working poor, but more can still be done. In particular, indexing the minimum wage to the annual increase in the median wage would ensure that workers who earn the minimum wage do not fall further behind the rest of the work force.

Poverty Measurements Recommendation • Adopt a new, updated poverty measurement to define eligibility for assistance programs as those programs are reauthorized. Public policies that provide safety nets for low-income families in this economic recession are critically important, as are antipoverty policies that contribute to the longterm financial security of these families. About 13.5 million children in the United States officially live in poverty (more than 20 64 percent of all children.) More than a third of older adults (14 million adults age 65 and older) and over two-fifths of children (32.7 million under age 18) struggle with economic insecurity, with incomes below 200 percent 65 of the federal poverty line. In order to understand the impact and effectiveness of policies and programs designed to reduce poverty, we need an accurate picture of the economic conditions in which low-income individuals and families live. The method by which poverty is currently measured in the United States was defined in 1963 based on data collected in 1955, when food expenses consumed most of the family budget. For over 40 years, the poverty measure has not changed though economic circumstances certainly have.

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The U.S. Census Bureau has recognized the inadequacy of the current measure and taken an initial step to make improvements by developing a Supplemental Poverty Measure. It will not replace the official poverty measure; rather it is an experimental measure that will be updated on an annual basis as new data, new methods, and further research become available. In addition to simply calculating a family’s income and cost of food, as the current formula does, the new measure will take into account modern expenses and in-kind benefits. Expenses include healthcare, childcare, housing, and utilities, and benefits and other income supports include EITC and SNAP. The first Supplemental Poverty Measure report was released in November 2011. It showed a decrease in child poverty but an increase in the poverty rate among seniors to 66 nearly 16 percent. While the Supplemental Poverty Measure is an improvement to how we measure poverty, it does not go far enough. Generations United supports efforts to modernize the official poverty measure and encourages Congress to make improvements that ensure children and seniors receive crucial supportive services. Generations United urges Congress to adopt a new poverty measure that properly reflects and defines eligibility for assistance programs as those programs are reauthorized.

Unemployment and Unemployment Insurance Recommendation • Automatically extend unemployment benefits beyond 26 weeks during economic downturns and expand eligibility to recent hires and individuals who work part-time. The unemployment insurance system is in serious need of modernization, especially given the current and continuing economic

Income Supports

downturn. Only a minority of workers are actually entitled to receive unemployment benefits when they lose a job through no fault of their own, and the percentage of wages replaced by benefits has fallen substantially over the past couple of decades. Further, the employment support system does little to assist those who are chronically underemployed—working parttime when full-time work is needed, or at jobs for which they are over-qualified. Making the job search particularly difficult for those with few skills is the reality that even the most basic jobs often require familiarity with computers and other technology that many poorly educated people lack. During times of high unemployment, their chances of finding remunerative employment are poor. Even when circumstances improve, they often confront employers who seek to extend the working day for existing workers rather than take on new workers—just in case the increased need for workers proves temporary. When many of the lowest-wage workers have not been in the workforce long enough to qualify for unemployment benefits when the economy falters, they find themselves forced back onto the TANF rolls. Families that have reached their time limit on TANF rolls have no safety net whatsoever. Also, a substantial number of the unemployed are exhausting all the unemployment benefits currently available and are unable to find work. A significant portion of this unemployed population are midlife and older workers, who may be too young to retire (although Social Security has seen a jump in early retirement claims for those 62 and older), but too “old” to be eligible for benefits such as TANF (in that they must have dependent minor children to qualify). Congress reauthorized federally funded unemployment insurance benefits for 2013. All states are eligible for the at least 14 weeks of benefits. States with higher

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unemployment rates are eligible for additional weeks (up to maximum of 47 weeks for states with an unemployment rate of at least 9 percent.) Another policy that can help keep more people in the workforce during times of economic distress is worksharing. Worksharing reduces work hours and spreads the remaining work among employees who might otherwise be laid off. Some states have amended their unemployment compensation laws to pay partial unemployment benefits to work-sharers. These work-share programs are voluntary, temporary programs that enable employers to retain experienced workers and allow employees to maintain their job skills. Work-sharing thus provides employers with an alternative to layoffs.

Family and Medical Leave Recommendations • Improve the Family and Medical Leave Act (FMLA) by expanding the definition of “covered” employers, such as through reducing the number of workers that must be employed. • Ensure that Family and Medical Leave Act coverage extends to ‘family-like’ relationships – such as grandfamilies – beyond parent-child, legally recognized spouses, etc. During a serious medical situation, an employed family member may face the difficult task of choosing between work and family. To lessen the stress, the Family and Medical Leave Act (FMLA) provides up to 12 weeks of unpaid, job-protected leave. FMLA provides protection when care for the employee, a parent, spouse or child of the employee is needed due to a serious health condition. FMLA leave may be taken all at once, or may be taken intermittently as the medical condition requires. Eligibility for FMLA is contingent on the following factors: employment by a “covered” employer, at

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least 12 months employment with a “covered” employer, an average work week of at least 24 hours for 12 months with “covered” employer, and work at a location where the “covered” employer has at least 50 employees within 75 miles of the worksite. Under the FMLA, employers are required to maintain the employee’s health insurance on the same terms as during employment and provide the same or similar job available to the employee upon the employee’s return to work. In 2010, the Department of Labor clarified FMLA interpretations to ensure that employees who are serving as a parent receives the parental rights to family leave regardless of their legal or biological relationship. This clarification specifically ensures that individuals such as grandparents or same sex partners are able to exercise leave rights under FMLA. Congress and the Administration must continue to ensure that FMLA protections cover all parent-like, and other family, caregiving situations, and that those protections cover as many workers as possible.

Nutrition Assistance Programs Recommendations • Enhance Supplemental Nutrition Assistance Program (SNAP) access and benefits through Farm Bill reauthorization. • Protect Supplemental Nutrition Assistance Program (SNAP) and other nutrition programs from negative structural changes, budget cuts and block grant proposals, particularly in the context of deficit reduction proposals. • Promote the expansion of the Commodity Supplemental Food Program (CSFP) to reach seniors in all 50 states. Increase food distribution through The Emergency Food Assistance Program (TEFAP).

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SNAP is the largest nutrition assistance program administered by the U. S. Department of Agriculture (USDA). More than one in seven Americans received SNAP 67 in July 2012. The goal of the program is “to alleviate hunger and malnutrition” by increasing food purchasing power for all eligible households who apply for participation” as stated in the Food Stamp Act of 1977, as amended (P.L. 108-269). The program provides monthly benefits that can be used to purchase food to eligible lowincome families. SNAP helps families become financially stable and make the transition to self-sufficiency, getting them through economic difficulties. Because SNAP benefits are available to most low-income households with few resources, regardless of age, disability status or family structure, SNAP households are a diverse group. For older adults, a particularly vulnerable and underserved population, participation in SNAP and other food assistance programs can help improve nutritional status and well-being and increase independence. Children who are well nourished may have better attendance at school and, once there, may be more focused on learning. Generations United supports enhancing SNAP nutritional education, outreach and enrollment and restoring benefit boosts through the pending Farm Bill reauthorization. Given that less than three in ten who are eligible receive SNAP – we also oppose cuts in the name of deficit reduction that will further reduce access to this crucial benefit. Other programs providing assistance to households are The Emergency Food Assistance Program (TEFAP) and the Commodity Supplemental Food Program (CSFP). TEFAP is important as a food source for households who cannot or will not access other food assistance programs, such as SNAP.

Income Supports

Generations United supports the sustained funding of The Emergency Food Assistance Program at levels that meet current needs in the midst of rising food and fuel costs. Mandatory funding levels should be increased through Farm Bill reauthorization to reflect increased demand and costs of providing assistance. CSFP was the precursor to the Women, Infants, and Children (WIC) program, discussed earlier in the Social Supports section of this Agenda. Today, nearly 97 percent of the more than 588,000 served each month are low-income older adults at 68 high risk for poor nutrition. Rather than the food vouchers that WIC provides, CSFP supplies nutritious monthly food packages. The program only operates in 39 states, the District of Columbia and two tribal nations. Generations United supports funding that sustains current caseloads but allows the six states with approved state plans to participate. More information about federal nutrition programs can be found in the Social Supports section of this Agenda. Children and Nutrition The most important developmental stage is early childhood, and that is when hunger and food security do the most harm. Teachers report they cannot teach hungry kids. Doctors and nurses report that hungry kids are sicker and run up medical costs. Children who go hungry in kindergarten are noticeably behind their peers in reading and math by third grade; and food insecurity and hunger drive poor birth outcomes, poor health and mental health outcomes, and childhood obesity: “When kids grow up undernourished, the architecture of their brains is changed, causing harm to their physical, mental, social and emotional health 69 throughout their lives.”

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Nearly half of all SNAP participants are 70 children. Nearly two-thirds (approximately 66 percent) of children served by SNAP are 71 school aged (5 to 17). Children receiving SNAP benefits are 26 percent less likely to be food insecure than eligible children not enrolled, and minority children are more likely to suffer food insecurity or poor health 72 when SNAP benefits are reduced. By reducing food insecurity, SNAP contributes to a reduction in hospitalization, deficits in cognitive development, and behavioral and emotional problems linked to hunger in children. More research needs to be done, but it also appears that access to SNAP benefits may actually reduce the incidence of obesity in children, a major 73 factor in lifelong illness.

Children receiving SNAP benefits are 26 percent less likely to be food insecure than eligible children not enrolled.

Low-Income Home Energy Assistance Program Recommendation • Restore Low-Income Home Energy Assistance Program (LIHEAP) funding to meet ongoing needs. The Low-Income Home Energy Assistance Program is authorized at $5.1 billion, but recent cuts have reduced funding to $3.5 billion. While the price of oil has fluctuated, the simultaneous increases in unemployment, health care costs and other negative economic effects are putting more vulnerable seniors and families at risk of arrears in their utility bills. At its peak, LIHEAP was helping households pay for nearly half of their home heating costs, but now the benefit only covers just over a third of the costs for the 8.9 million on the program. Generations United urges the support of this vital program to meet the pressing demand.

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Health Care

Intergenerational Intersection ccess to affordable, high-quality health

A

care coverage has critical implications

for children, youth, individuals with disabilities, families, and older adults. Strategic investments in the health and well-being of all generations not only improve the lives of individuals, their families, and communities, such investments yield very high returns related to increased worker productivity, lower cost medical interventions at all stages of life, and a stable public health infrastructure better prepared to handle health emer-

technology to securely manage medical information and research comparing the effectiveness of different kinds of procedures -- provide better, more affordable care and improve the country’s long-term fiscal outlook. The Affordable Care Act also requires that health care services equally address physical and mental health needs and that health insurance coverage for mental illnesses be on par with coverage provided for physical illnesses. Generations United recognizes the importance of interactions between physical and mental health, as well as the effects that health problems of caregivers and those they are caring for can have on one another.

gencies.

Issues and Recommendations Position Statement Generations United is committed to improving access, protections, coverage, and services for children, older adults, families, and caregivers and emphasizes the importance of meeting the health care needs of the most vulnerable people. Generations United supports full implementation of the Affordable Care Act as it expands affordable, quality health care coverage to the uninsured, while bringing down costs throughout the nation’s health care system. The Affordable Care Act impacts health care for all generations and mandates investments in prevention strategies across the lifespan. These strategic investments include regular and coordinated prenatal care, pediatric care for children, and chronic disease management for older adults, all of which reduce future incidences of costly emergency interventions involving surgery and expensive medications. Innovations and improvements in health care delivery systems – such as using information

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Affordable Care Act Recommendations • Fully implement the Affordable Care Act and ensure with its implementation that children, youth, and older adults continue to receive quality, comprehensive, and age appropriate benefits without any disruption in care. • Encourage states to adopt the Medicaid expansion under the Affordable Care Act, which was rendered optional for states by the decision of the Supreme Court in National Federation of Independent Business v. Sebelius. • Encourage Congress to protect the resources for implementation and services provided by the Affordable Care Act. Between the Supreme Court’s upholding of the Affordable Care Act’s constitutionality and the results of the 2012 Presidential and Congressional elections, it now seems assured that the Affordable Care Act will be


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fully implemented. There is still much work to be done to ensure that the law is implemented effectively. Since the enactment of the Affordable Care Act, both the Obama Administration and the Congress have used some of the resources provided in the act for preventative services to fund other functions of government. There have also been repeated attempts in the Congress to “defund” or reduce funds available to the states for implementation of the law. Efforts to use these funds for other purposes will result in a slowdown or stop to implementation and should be avoided.

Health Exchanges

Photo by June Stiehm

The health exchanges are governmentregulated marketplaces of insurance plans with different tiers or levels of coverage, offered to individuals without health care or to small companies. Beginning in 2014, individuals will be able to buy insurance directly in an exchange. Exchanges will offer a choice of health plans that meet certain benefits and cost standards. Starting in 2014, Members of Congress will be getting their health care insurance through exchanges. Presumably, the presence of government-regulated exchanges will, like any functioning market, bring prices down so that personal and employer-provided insurance is both comprehensive and competitive.

The Medicaid expansion was responsible for more than half of the insurance coverage expansion under the Affordable Care Act. For those states that do not choose to take up the Medicaid expansion, many lowincome people who otherwise would have gained coverage will be left with no real health insurance options. For this reason, it is important that states take up the expansion. See below for additional information on Medicaid coverage.

Medicaid Expansion While the Supreme Court upheld the constitutionality of the Affordable Care Act, the court ruled that threatening to withhold all of a state’s Medicaid funding if that state refuses to take up the Medicaid expansion is unconstitutional. Consequently, expanding Medicaid in 2014 to all persons up to 133% of the federal poverty line – originally required by the law – is now simply an option that states can take up or not.

Medicare, Medicaid, and CHIP Recommendations • Ensure access to Medicaid and CHIP for children and families who are eligible, but not enrolled. • Increase access to qualified providers accepting Medicaid and CHIP and ensure that providers are adequately trained to meet both the physical and mental health needs of vulnerable children and families. Generations United supports federal health programs that meet quality standards and provide basic patient protections such as Medicare, Medicaid, and CHIP. Generations

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United will monitor the implementation of standards within federal programs and support legislation, where necessary, to enact further patient protections and protect quality of care. Generations United will also support implementation of the Affordable Care Act to ensure coverage of all children, along with necessary changes to existing federal programs so that everyone in America has access to quality, affordable health care.

Medicare Medicare is a federal health insurance program for people 65 years of age and older, as well as other groups, including some people with disabilities who are younger than 65 and people with end-stage renal failure. Medicare coverage has four components: Part A covers hospital and other costs; Part B addresses outpatient medical care; Part C provides private health insurance options under Medicare Advantage plans; and Part D provides access to several prescription drug plans.

Medicaid Under current Medicaid requirements, states must cover children under age 6 and pregnant women under 133 percent of federal poverty level. Children ages 6-18 must be covered up to 100 percent of federal poverty level. The Affordable Care Act expands Medicaid – for states that choose to take up the expansion – to a national minimum of 133 percent of federal poverty level ($14,856 for an individual or about $30,657 for a family of four in 2012), in 2014. States still have the flexibility to expand, or continue to provide, coverage to adults above 133 percent at regular state matching rates. Under the Affordable Care Act, Medicaid also expands coverage to include children up

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to age 26 who "age-out" of foster care after 18. Beginning in 2014, these young people will be eligible to continue receiving Medicaid and Early Periodic Screening, Diagnosis, and Treatment (EPSDT) benefits. Beginning in 2015, children covered by CHIP between 100 percent and 133 percent of poverty will be transitioned to Medicaid coverage. Individuals eligible for Medicaid would not be eligible for subsidies in the state exchange. The new law establishes a new eligibility category for all non-pregnant, non-Medicare eligible childless adults under age 65 who are not otherwise eligible for Medicaid. In order to assist states with all of the newly eligible individuals, the new law provides full federal financing for those newly eligible for Medicaid for 2014-2016, down to 90 percent of the Federal Medical Assistance Percentages (FMAP) – which are used to determine the amount of Federal matching funds for State expenditures for Medicaid -for 2020 and beyond.

Children’s Health Insurance Program (CHIP) The Affordable Care Act provides funding for CHIP through 2015 (originally set to expire in 2013), and continues the authority for the program through 2019. It also extends and increases funding provided in Children’s Health Insurance Program Reauthorization Act (CHIPRA) for Medicaid and CHIP enrollment and renewal activities from $100 million through 2013 to $140 million through 2015. CHIPRA enrollment bonuses are not extended beyond 2013. CHIP eligible children who cannot enroll in the program due to federal allotment caps must be screened to determine if they are eligible for Medicaid. If they are not eligible for Medicaid, they will be eligible for tax credits in a plan in the exchange, which is certified by April 2015 by the HHS Secretary to be comparable to CHIP.

Health Care

Medicaid and CHIP rules that require states to establish a five-year waiting period for lawfully residing adults (with state option to waive the waiting period for children and pregnant women) will not change as a result of the Affordable Care Act. Legal immigrants not eligible for Medicaid or CHIP can obtain coverage in the exchange and receive premium and cost-sharing subsidies based on their income. Undocumented immigrants will remain ineligible for Medicaid and CHIP, and cannot obtain coverage through the exchanges.

Long-Term Services and Supports Recommendations • Support continued initiatives to expand and improve long-term services and supports through improvements in Medicare, Medicaid, and other programs to provide better coverage for home and communitybased care. • Encourage a national conversation about the financing of long-term care and continue to promote the goals embodied in the Community Living Assistance Services and Supports (CLASS) program. • Discourage states from cutting Medicaid home and community-based services, and encourage them to adopt new options under the Affordable Care Act, including the Community First Choice and Balanced Incentives Programs. The country needs a cohesive national strategy to preserve the dignity and independence of older adults, and children and adults with disabilities, many of whom face challenges in maintaining connections to their families and communities. After years of working, many older adults now have no choice but to impoverish themselves and their families to receive the help they need under Medicaid. Many parents of children

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with disabilities sacrifice employment, career opportunities, and important sources of income so their children remain eligible for critical Medicaid services. Reforms should help older adults, children and adults with disabilities, and their families maintain financial stability and improve access to home- and community-based services, regardless of income. The Affordable Care Act included the CLASS Act (Community Living Assistance Services and Support Act), a voluntary, federally-administered, consumer-financed insurance plan. However, implementation of the CLASS Act was put on hold by Secretary Sebelius and the Obama Administration because of questions about the viability and the sustainability of the program. In Lieu of the CLASS Act Congress created the Long Term Care Commission in the America TaxPayer Relief Act of 2012. The CLASS program is important because it offers a solution to this financing challenge that is different from what is currently available in the private market. While a national conversation about financing of long-term care is needed, CLASS should not be abandoned. Long-term supports and services should increase access to information and resources; enable older adults and children and adults with disabilities to remain in their homes, stay connected to their families and engaged in their communities, and provide more choices that strengthen family and caregiver support networks. States should be strongly discouraged from cutting Medicaid home and communitybased services, and should be encouraged to adopt new options under the Affordable Care Act, including the Community First Choice and Balanced Incentives Programs.

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Mental Health Services Recommendation • Ensure the implementation of the Mental Health Parity and Addiction Equity Act of 2008 that requires health insurance companies to place coverage of mental health illnesses on par with coverage for physical health issues. Effective mental health services for children can lay the groundwork for positive social and emotional development. Mental health services can help meet the special needs of the increasing number of children and youth who are homeless, at risk, and/or in the child welfare system. Services that support the mental health and wellbeing of older adults can help mitigate the effects of emotional and behavioral issues arising from failing health and other difficult life events and social isolation. Caregivers who support loved ones who are frail and older, disabled or chronically or terminally ill, should have access to mental health services since they are more likely to experience feelings of stress, isolation, and depression. Because physical and mental health issues are inextricably linked, mental health issues must be given equal attention and consideration. It is especially important that the Mental Health Parity and Addiction Equity Act of 2008, which passed during the 110th Congress, and guarantees mental health parity, be fully implemented to truly benefit children and adults so they have access to mental health services.

Health Care Reform for Children and Youth Recommendation • Ensure that the Affordable Care Act’s reforms for children and youth are fully implemented. The Affordable Care Act improves the quality of care for children, in addition to

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expanding coverage to improve their access to care. Prohibiting Pre-Existing Condition Exclusions for Children, Dependent Coverage, and Prevention and Wellness Many of the safety nets that vulnerable children and families depend on are expanded in the new law. The Affordable Care Act protects consumers by barring health insurance companies from imposing pre-existing condition exclusions on children’s coverage. Further, the new health plans and certain grandfathered plans will be required to allow unmarried, childless adults up to age 26 to remain on their parents’ insurance policy. New plans will also be required to cover preventive services (including evidence-informed preventive care and screenings) and immunizations without co-pays, deductibles or other cost-sharing requirements in order to ease the financial burdens on families. Home Visiting - The enactment of the Affordable Care Act created a dedicated federal funding stream to strengthen home visitation programs by improving coordination of services for at-risk communities, improving outcomes for families who reside in at risk communities, and identifying and providing comprehensive services. The Act requires each state to conduct a statewide needs assessment that identifies communities with high concentrations of poor maternal and child health outcomes as well as the quality and capacity of existing programs or initiatives in the state. The Affordable Care Act also authorizes $1.5 billion over five years to carry out a new grant program. Eligible programs have to meet certain outcome-related benchmarks in addition to addressing maternal and child health, including childhood injury prevention, school readiness, juvenile delinquency, family economic factors, and coordination with community resources. While these grants are

Health Care

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Photo by Julie Jones Green

designed to fund a range of evidence-based home visitation programs for young children and families, priority funding is dedicated to evidenced-based models. In addition, Indian Tribes and nonprofit organizations are also eligible to apply for grant funding so long as they meet the requirements of the grant program. Youth in Foster Care - The Affordable Care Act strengthens the Fostering Connections Act by requiring that the transition plan for children aging out of foster care include information about the importance of designating another individual to make health care treatment decisions on behalf of the youth if he/she becomes unable to do so and including information on options for health insurance. The Affordable Care Act requires states to certify that youth in care and former foster youth are receiving independent living services, which educate

the youth on the importance of designating another individual to make health care treatment decisions on behalf of the youth if he/she becomes unable to do so. Family to Family Health Information Centers - The American Taxpayer Relief Act of 2012 extended funding for the Family-toFamily Health Information Centers through 2013. Created in 2005, Family-to-Family Information Centers provide information, education, training, outreach, and peer support to families of children and youth with special health care needs and the professionals who serve them. The centers are operated by family leaders who have children with special health care needs and expertise in federal and state public and private health care systems, as well as by health professionals.

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Tax and Budget Issues

Intergenerational Intersection

S

table economy and responsible fiscal policies are critical to the

health and well-being of all generations. Adequate tax revenues are essential to support the programs that address the needs of all ages. Investing in supportive programs for children today helps prepare them for productive employment to ensure the nation’s future prosperity. And providing adequate services for seniors helps ensure their continued participation in civic life and their availability as role models and mentors to the young. Children and seniors must be priorities in the revenue and spending decisions of policy-makers and elected officials.

Position Statement Generations United recognizes that a stable economy is essential for all generations to thrive. The tax code should promote balanced economic growth and generate revenues based on people’s ability to pay taxes. Entitlement programs, including tax entitlements, need keep pace with demographic changes. Tax policy should ensure there are resources to fund necessary programs for people of all ages, paying special attention to low- and moderate-income individuals and families, including those providing care to relatives. During economic downturns, care should be taken to avoid program and eligibility cuts that have especially serious long-term consequences for vulnerable populations. Structural budget deficits

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should be addressed when the economy is robust, insofar as they create interest costs that hinder our ability to finance the retirement of the boomer generation, the special needs of the young and the poor, and the health and long-term care needs of the oldest population. As budget deficits are properly regarded as a debt owed to the next generation, Generations United supports fiscal discipline.

Issues and Recommendations The Economic Environment Recommendations • Ensure that appropriate funding is not reduced, and that federal and state tax and budget policies provide sufficient revenues, to maintain crucial programs for all generations, including those that promote health security, retirement savings, and sustainable Medicare and Social Security. • Ensure that tax cuts, tax expenditures and tax subsidies for the wealthy and corporations balance the needs of economic growth and investment in the future to assure that they do not undermine our nation’s long-term growth and budget sustainability. The federal government and states are facing budget crises and are reacting by paring back human services and discretionary spending to bare bones levels. State FY 2013 budget gaps that were addressed with budget cuts and offsets amounted to $55 billion in 31 states. This amount is likely to continue to grow, especially in those states where revenue increases are unlikely. Families hit hard by the recession are likely to continue to experience the loss of vital services. The primary sources of the projected expenditure growth in entitlement programs


are demographic changes (the aging of the population) and rapidly rising health care costs. Together these factors will cause Medicare, Medicaid, and Social Security obligations to continue to grow considerably faster than the economy. The federal budget deficit, which was $1.1 trillion in 2012, is projected to fall only slightly; as a result, significant efforts are underway in Washington to curb spending and reduce the deficit. The 113th Congress may consider proposals including raising the Social Security retirement age, taxing capital gains as ordinary income, block-granting Medicaid, providing premium-support for Medicare and capping tax revenues at some arbitrary percentage of gross domestic product. Generations United supports the philosophy that an increasing federal deficit threatens the health of federal programs and other societal supports that we as a nation need to move towards reducing the federal deficit. However, vital supports that serve all Americans have already faced severe cuts. When considering deficit reduction, we urge Congress to consider all aspects of the federal budget including revenues, and to not further jeopardize important resources for children, families and older adults, or save certain programs at the expense of others.

The Child Tax Credit Recommendations • Permanently lower the Child Tax Credit minimum income threshold to zero so the lowest income families can participate. • Make the Child Tax Credit fully refundable so those with the lowest incomes can get the full benefit of the credit. • Make the current $1,000 maximum credit amount permanent. Current tax law provides a partially refundable Child Tax Credit (CTC) for most

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Photo by David Dunn

families who owe taxes to help them with the costs of raising a child. The credit is up to $1,000 per child under 17 years old per year. The Recovery Act temporarily lowered the eligibility level in 2009 and 2010 so that a parent earning at least $3,000 could qualify for the credit. This provision helped millions more children for the first time and helped prevent one million children from descending into poverty. Because the child tax credit is not fully refundable, families whose incomes are so low that no income taxes are owed do not benefit from the credit. Although these families may pay no income taxes, they pay significant payroll, sales, and other taxes. Generations United supports permanently lowering the CTC minimum income threshold to zero, so the lowest income families can participate. The CTC should also be made fully refundable so those with the lowest incomes can get the full benefit of the credit. Finally, the current $1,000 maximum credit amount needs to be made permanent as well.

When considering deficit reduction, we urge Congress to consider all aspects of the federal budget including revenues, and to not further jeopardize important resources for children, families and older adults, or save certain programs at the expense of others.

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and allow it to apply to low-income singles and couples who cannot afford to retire so it can benefit some of the neediest seniors working at or near minimum wage. • Eliminate the upper age limit of 65 years old for filers without children claiming the EITC.

Family caregivers often must take time off from work or even leave the workforce entirely in order to meet their caregiving responsibilities. This care comes at great expense to the caregiver, while in the aggregate it saves the government billions of dollars that would otherwise have to be spent on alternatives to uncompensated caregiving. A refundable Caregiver Tax Credit would provide needed support to anyone who provides care, whether to disabled parents, a spouse or a child. More information about family caregiving can be found in the section of this Agenda entitled Grandparents and Other Relatives Raising Children and Other Family Caregiving.

Studies have shown that among working families, the EITC lifts substantially more children out of poverty than any other government program, reducing child poverty by nearly one-quarter and providing substantial positive effects in encouraging 74 single parents to enter the workforce. “Qualifying children” for EITC eligibility include grandchildren, nieces, nephews, and other children if they have lived with and were cared for by the taxpayer for a minimum of six months to a year, depending on the relationship to the child. The poverty rate of children in families with three or more related children in the U.S. is more than twice the poverty rate of children in families with two children. Yet currently the only distinction made in the EITC is between families with one child and families with two or more children. In response to the recession, the Recovery Act expanded the EITC over two years for families with three or more children. Permanently expanding the EITC to establish a multi-tier payment structure would make the program more responsive to the needs of larger families. Allowing it to apply to lowincome singles and couples who cannot afford to retire would benefit some of the neediest seniors working at or near the minimum wage.

Earned Income Tax Credit (EITC) Recommendations

Adoption Tax Credit Recommendations

• Permanently expand the Earned Income Tax Credit to establish a multi-tier payment structure to make the program more responsive to the needs of larger families,

• Make the Adoption Tax Credit permanent and protect it from changes that would

Photo by Karen Peterson

Caregiver Tax Credit Recommendation • Create a refundable Caregiver Tax Credit to provide needed support to anyone who provides care, whether to disabled parents, a spouse or a child.

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Tax and Budget Issues

reduce the number of qualified adoptive parents. The Adoption Tax Credit was created in 1996, via the Adoption Assistance Program, to help with the cost of adoption and to encourage adoption. In 2001, Congress extended the credit through December 2010, and increased the value of the credit to $10,000, up from $5000. The enactment of the Affordable Care Act and subsequent Health Care and Education Reconciliation Act, again increased the value of the credit to $13,170, and made the credit refundable for all types of adoptions, allowing families with small tax liabilities to better access the credit. Qualifying expenses for the Adoption Tax Credit include reasonable and necessary adoption fees, court costs, attorney fees, traveling expenses, and other expenses directly related to and for which the principal purpose is the legal adoption of an eligible

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child. An eligible child must be under 18 years old or be physically or mentally incapable of independent care. A taxpayer also may be eligible to take an increased credit or exclusion for expenses related to the adoption of a child with special needs if the child otherwise meets the definition of qualifying child, is a United States citizen or resident, and a state determines that the child cannot or should not be returned to his or her parent's home and probably will not be adopted unless assistance is provided.

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American Community Survey (ACS) 2001, Table B09006, Relationship to Householder for Children Under 18 Years in Households. Accessed October 18, 2012 at http://factfinder2.census.gov/faces/tableservices/jsf/pages/productview.xhtml?pid=ACS_11_1YR_B0900 6&prodType=table American Community Survey (ACS) 2011, Table S1001, Grandchildren Characteristics Accessed October 18, 2012 at http://factfinder2.census.gov/faces/tableservices/jsf/pages/productview.xhtml?pid=ACS_11_1YR_S1001 &prodType=table. These two numbers only concern children being raised by their grandparents. Similar data is not available for other relatives raising children. American Community Survey (ACS) 2011, Table S1002, Grandparents. Accessed October 18, 2012 at http://factfinder2.census.gov/faces/tableservices/jsf/pages/productview.xhtml?pid=ACS_11_1YR_S1002 &prodType=table ibid ibid Generations United (2009). GrandFacts: Data, Interpretation, and Implications for Caregivers. Accessed March 13, 2011 at http://www.gu.org/LinkClick.aspx?fileticket=btAQd43vSqQ%3d&tabid=157&mid=606. Gleason, J. (October, 2012). “Kinship Care in the United States, What the Research Tells Us.” Presentation at Congressional Lunch Briefing sponsored by Women’s Policy Inc., Congressional Caucus for Women’s Issues, and the Annie E. Casey Foundation. Accessed January 30, 2013 at http://www.womenspolicy.org/site/DocServer/Dr._Gleeson_presentation.pdf?docID=4642 Hayslip, B. and Kaminski, P. (2005). Grandparents Raising Their Grandchildren: A Review of the Literature and Suggestions for Practice. The Gerontologist 42(2), 262-269. Children’s Bureau, Child Maltreatment 2010, Table 3-6 (number of unique victims) Children’s Bureau, Child Maltreatment 2010, Table 6-4 (number of unique victims) Annie E. Casey Foundation Kids Count Data Center (2012). “Stepping Up for Kids: What Government and Communities Should Do to Support Kinship Families.” Warren, R., & Cohen, S. (1985). Respite care. Rehabilitation Literature, 46(3-4), 66-71. ARCH, The National Assistance Center for Lifespan Respite (2010). Fact Sheet No. 45, Respite Services to Support Grandfamilies. Accessed March 13, 2011 at http://www.archrespite.org/images/docs/Factsheets/FS_45-Grandparents_Grandchildren.pdf Family Caregiving Alliance. National Center on Caregiving. Selected Caregiver Statistics. Accessed March 13, 2011 from http://www.caregiver.org/caregiver/jsp/content_node.jsp?nodeid=439&expand.nodeid=838 National Alliance for Caregiving (2010) .The Metlife Study of Working Caregivers and Employer Health Care Costs. Accessed March 13, 2011 at http://www.caregiving.org/data/Caregiver_Costs_Study_Web_FINAL_2-12-10.pdf ibid ibid ibid ARCH, The National Assistance Center for Lifespan Respite. (2010). Fact Sheet No. 45 Respite Services to Support Grandfamilies. Access March 13, 2011 at http://www.archrespite.org/images/docs/Factsheets/FS_45Grandparents_Grandchildren.pdf ibid ibid Laughlin, L. (2010). Who’s Minding the Kids? Child Care Arrangements: Spring 2005 and Summer 2006. Current Population Reports, p 70-121. U.S. Census Bureau. Accessed March 13 2011 at http://www.census.gov/prod/2010pubs/p70-121.pdf Adams. G., Zaslow, M. Tout, K. (2007). Early Care and Education for Childcare in Low-Income Families. Patterns of use, Quality and Potential Policy Implications. The Urban Institute. Accessed March 15, 2011 at http://www.urban.org/url.cfm?ID=411482. U.S. Government Accountability Office (2010). Child Care: Multiple Factors Could Have Contributed to the Recent Decline in the Number of Children Whose Families Receive Subsidies. Accessed March 11, 2011 at http://www.gao.gov/new.items/d10344.pdf . Foundation for Child Development (June, 2012). “Children in Immigrant Families: Essential to America’s Future). Accessed December 3, 2012 at http://fcdus.org/sites/default/files/FINAL%20Children%20in%20Immigrant%20Families%20(2)_0.pdf


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American Public Human Services Association (September, 2012). State’s Utilization of SSBG Funds and its Impact on Services. Accessed January 29, 2013 at http://www.aphsa.org/Home/Doc/SSBGReport.pdf. U.S. Administration on Aging, National Center on Elder Abuse (2008). National Elder Abuse Incidence Study. Accessed March 15, 2011 at http://www.aoa.gov/AoARoot/AoA_Programs/Elder_Rights/Elder_Abuse/docs/ABuseReport_Full.pdf National Center on Elder Abuse (2010). Why Should I Care About Elder Abuse. Accessed March 13, 2011 at http://www.ncea.aoa.gov/Ncearoot/Main_Site/pdf/publication/NCEA_WhatIsAbuse-2010.pdf U.S. Department of Agriculture Food and Nutrition Service. Child and Adult Care Food Program. Accessed March 16, 2011 at http://www.fns.usda.gov/cnd/Care/ . U.S. Administration on Aging, Elderly Nutrition Program. Accessed March 15, 2011 at http://www.aoa.gov/aoaroot/Press_Room/Products_Materials/fact/pdf/Elderly_Nutrition_Program.pdf Meals on Wheels Association of America, The Face of Senior Hunger. Accessed March 13, 2011 from https://www.mowaa.org/Page.aspx?pid=282 U.S. Census Bureau. Accessed March 13, 2011 from http://www.census.gov/prod/1/pop/p23190/p23190-f.pdf. Jarrott, Shannon. & Kelly Bruno. “Intergenerational activities involving person with dementia: An observational assessment.” American Journal of Alzheimer’s Disease and Other Dementias. Vol 18, No. 1 (2003) p. 31-37. Zero to Three. (2010). Zero to Three Policy Pocket Card, Reference List. Accessed March 17, 2011 at http://www.zerotothree.org/public-policy/policy-toolkit/pocket-card-reference-list.pdf. ibid Pre[k] Now. The Benefits of High Quality Pre-K. Accessed March 15, 2011 at http://www.preknow.org/policy/factsheets/benefits.cfm ibid ibid Heckman, J. Letter to National Commission on Fiscal Responsibility and Budget Reform. Accessed on March 13, 2011 from http://www.heckmanequation.org/system/files/FederalCommision_2.10.11FINAL.pdf National Association of Child Care Resource and Referral Agencies (2007). Parents and the High Price of Child Care. Accessed March 11, 2011 at http://www.naccrra.org/docs/press/price_report.pdf. ASPE Issue Brief (April 2010). Estimates of Child Care eligibility and Receipt for Fiscal Year 2006. U.S. Department of Health and Human Services. Accessed March 13, 2011 at http://aspe.hhs.gov/hsp/10/cceligibility/ib.shtml#ap2 Laughlin, L. (2010). Who’s Minding the Kids? Child Care Arrangements: Spring 2005 and Summer 2006. Current Population Reports, p 70-121. U.S. Census Bureau. Accessed March 13 2011 at http://www.census.gov/prod/2010pubs/p70-121.pdf Adams. G., Zaslow, M. Tout, K. (2007). Early Care and Education for Childcare in Low-Income Families. Patterns of use, Quality and Potential Policy Implications. The Urban Institute. Accessed March 15, 2011 at http://www.urban.org/url.cfm?ID=411482. Shulman, K. and Blank, H. (2010). Supporting State Child Care Efforts with American Recovery and Reinvestment Act Funds. National Women’s Law Center. Accessed March 13, 2011 at http://www.nwlc.org/sites/default/files/pdfs/SupportingStateChildCareEffortsWithARRA.pdf U.S. Government Accountability Office (2010). Child Care: Multiple Factors Could Have Contributed to the Recent Decline in the Number of Children Whose Families Receive Subsidies. Accessed March 11, 2011 at http://www.gao.gov/new.items/d10344.pdf . Pre[k] Now. The Benefits of High Quality Pre-K. Accessed March 15, 2011 at http://www.preknow.org/policy/factsheets/benefits.cfm Peter D. Hart Research Associates (2003). The New Face of Retirement: An Ongoing Survey of American Attitudes on Aging. Civic Ventures. Accessed March 16, 2011 at http://www.civicventures.org/publications/surveys/new_face_of_retirement/2002_survey_analysis.pdf Rosebrook, V. (2007). Intergenerational Personal/Social Skills Development Study. Childhood Education. Vol. 83, No. 3, pp. 162-4; Peter D. Hart Research Associates. (2003). The New Face of Retirement: An Ongoing Survey of American Attitudes on Aging. Civic Ventures. Accessed March 16, 2011 at http://www.civicventures.org/publications/surveys/new_face_of_retirement/2002_survey_analysis.pdf

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Rosebrook, V. (2007). Intergenerational Personal/Social Skills Development Study. Childhood Education. Vol. 83, No. 3, pp. 162-4. 50 ibid 51 Jarrott, S. and Bruno. K. (2003). Intergenerational Activities Involving Persons with Dementia: An Observational Assessment. American Journal of Alzheimer’s Disease and Other Dementias. Vol. 18, No. 1, pp. 31-37. 52 Peter D. Hart Research Associates (2003). The New Face of Retirement: An Ongoing Survey of American Attitudes on Aging. Civic Ventures. Accessed March 16, 2011 at http://www.civicventures.org/publications/surveys/new_face_of_retirement/2002_survey_analysis.pdf 53 Bailey, L. (2004). Aging Americans: Stranded without Options. Surface Transportation Policy Project. Accessed March 15, 2011 at http://www.transact.org/library/reports_html/seniors/aging.pdf. 54 U.S. Census Bureau (2012). Income, Poverty and Health Insurance Coverage in the United States: 2011. Accessed January 20, 2013 at http://www.census.gov/prod/2012pubs/p60-243.pdf 55 Lavery, J and Reno. V. (2008). Children’s Stake in Social Security. Social Security Brief. No. 27. National Academy of Social Insurance. Accessed March 15, 2011 at http://www.nasi.org/sites/default/files/research/SS_Brief_027.pdf 56 USDA Food and Nutrition Services, Office of Research and Analysis (April, 2012).Building a Health America: A Profile of the Supplemental Nutrition Assistance Program. Accessed October 9, 2012 at http://www.fns.usda.gov/ORA/menu/Published/SNAP/FILES/Other/BuildingHealthyAmerica.pdf 57 Pavetti, L. and Rosenbaum, D. (2010). Creating a Safety Net That Works When the Economy Doesn’t: The Role of the Food Stamp and TANF Programs. Center on Budget and Policy Priorities. 58 ibid 59 U.S. Social Security Administration (2009). Survivor’s Benefits. SSA Publication No. 05-10084. Accessed March 15, 2011 at http://www.socialsecurity.gov/pubs/10084.pdf 60 Social Security Online. How much work do you need for benefits for your children. Accessed March 16, 2011 at http://www.socialsecurity.gov/kids/parent4.htm 61 Social Security Online. Fact Sheet: Social Security. Accessed March 16, 2011 at http://www.socialsecurity.gov/pressoffice/factsheets/basicfact-alt.pdf.; U.S. Social Security Administration, Office of Retirement and Disability Policy. Annual Statistical Supplement 2010. http://www.socialsecurity.gov/policy/docs/statcomps/supplement/2010/5f.html#table5.f4 62 Ruffing, K. (2010) Thousands of Poor Refugees Face Loss of SSI Benefits Lawmakers Should Act to Preserve Lifeline for Vulnerable Group. Center on Budget and Policy Priorities. 63 Annie E. Casey Foundation (2009). KIDS COUNT Indicator Brief: Reducing the Child Poverty Rate. Accessed March 16. 2011 at http://www.aecf.org/~/media/Pubs/Initiatives/KIDS%20COUNT/K/KIDSCOUNTIndicatorBriefReducingthe ChildPovert/reducingchildpoverty.pdf 64 U.S. Census Bureau (September, 2012). Income, Poverty and Health Insurance Coverage in the United States:2001 Current Population Reports. Accessed February 1, 2013 at http://www.census.gov/prod/2012pubs/p60-243.pdf 65 Ibid 66 U.S. Census Bureau (November, 2012). The Research Supplemental Poverty Measure 2010. Accessed February 1, 2013 at http://www.census.gov/prod/2011pubs/p60-241.pdf 67 Food Research Action Center. Accessed February 1, 2013 at http://frac.org/reports-and-resources/snapfood-stamp-monthly-participation-data/#2jul 68 USDA Food and Nutrition Assistance Data and Statistics. Accessed February 1, 2013 at http://www.fns.usda.gov/fns/key_data/september-2011.pdf 69 Partnership for America’s Economic Success. (2008). Reading, Writing and Hungry. Accessed March 14, 2011 at http://www.pewcenteronthestates.org/uploadedFiles/Final%20Online%20Brief.pdf. 70 USDA Food and Nutrition Service, Office of Research and Analysis (April, 2012). Building a Healthy America: A Profile of the Supplemental Nutrition Assistance Program. Accessed February 1, 2013 at http://www.fns.usda.gov/ORA/menu/Published/SNAP/FILES/Other/BuildingHealthyAmerica.pdf 71 Food Research and Action Center. Accessed March 16, 2011 at http://frac.org/pdf/effect_on_children.pdf 72 Ibid 73 Ibid 741 Holt. S. (2006). The Earned Income Tax Credit at Age 30: What We Know. The Brookings Institution. Accessed March 16, 2011 at http://www.brookings.edu/metro/pubs/20060209_Holt.pdf 49

Generations United

Public Policy Committee

Co-Chairs Amy Gotwals Senior Director of Public Policy and Advocacy National Association of Area Agencies on Aging Hayling Price Policy Director National Human Services Assembly

Stefanie Sprow Policy Associate, Child Welfare and Mental Health Children’s Defense Fund Jaclyn Szrom Senior Federal Policy Analyst ZERO TO THREE Joe Theissen Consultant Voices for America’s Children

Organizational Members Patty Cole Director of Government Relations, Policy Center ZERO TO THREE Jennifer Dexter Assistant Vice President, Government Relations Easter Seals Barbara Gay Director of Government Affairs LeadingAge Suzanne Lay Government Affairs Associate, Child Welfare Child Welfare League of America Marci Phillips Director of Policy and Advocacy National Council on Aging Kayleigh Rogers-Torres Public Policy Associate National Association for the Education of Young Children Marilina Sanz Associate Legislative Director National Association of Counties

Robert Francis Director of Advocacy and Policy Lutheran Services in America Yvonne Tobias Policy Integration Manager AARP YaMinco Varner Government Affairs Associate, Health Child Welfare League of America

Generations United Staff Jaia Peterson Lent Deputy Executive Director

www.gu.org