Agenda - Council Work Session - 03/08/2022

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4364 Federal Register/Vol. 87, No. 18/Thursday, January 27, 2022/Rules and Regulations to parents.Parents, especially mothers, weeks).140 In addition to heightened COVID-19 on pregnant and recently may face challenges reentering or health risks from COVID-19,pregnant pregnant individuals,Treasury is re- remaining in the workforce if early individuals may have experienced categorizing home visiting services as an learning services are unavailable. significant changes to their prenatal care eligible use for impacted communities, Treasury Response:Childcare and during the pandemic 141 or may also not just disproportionately impacted Early Learning Services:Treasury agrees have experienced increased mental communities. Under the final rule,these with commenters'analysis that health challenges, including high levels eligible uses are available to impacted challenges accessing or affording of depression, anxiety,loneliness,and households or classes of households. childcare have been widespread during post-traumatic stress during the Public Comment:Child Welfare: the pandemic,affecting many pandemic.142 While the interim final rule noted that jurisdictions and populations across the Home visiting services provided to certain types of assistance,particularly country.Disruptions to early care and families,particularly new mothers and around child development and learning services similarly have had newborns, feature regular home visits parenting,were eligible for child broad impact and likely result in from trained nurses, social workers, welfare-involved families,Treasury has negative impacts for young children and and/or counselors who provide health received some recipient questions their parents.As such,these care,mental health resources,positive asking whether financial, educational, enumerated eligible uses are generally parenting support, support in making housing, or other supports and services responsive to the negative economic personal health decisions, and are eligible uses for foster youth, impacts of the pandemic in all awareness of other potentially helpful including those aging out of the system, communities,not just in services. These functions have become and child welfare-involved families. disproportionately impacted even more essential at mitigating Other commenters asked about whether communities. Under the final rule, negative factors associated with the funding for kinship care would be childcare and early learning services are pandemic.Home visits give eligible. available to impacted households or professionals a chance to flag potential Background:Child Welfare:The classes of households,not just those domestic violence,which has risen COVID-19 pandemic placed meaningful disproportionately impacted. These worldwide over the course of the strain on the child welfare and foster eligible uses can include new or pandemic.143 Racial health disparities care system. Court hearings were expanded services,increasing access to can also be driven down by home visits. delayed,146 essential mental health care services,efforts to bolster,support, or For example,Black women are more was shifted to a virtual environment, preserve existing providers and services, likely to avoid hospitals during the and attendance and performance in and similar activities. pandemic,and home visitors can help school among foster children dropped Further,Treasury is clarifying that either assuage concerns around sharply.147 Additionally,there was a improvements to or new construction of hospitals or give effective advice for nationwide rise of new children childcare, daycare,and early learning alternative methods of childbirth.144 entering the foster care system and facilities are eligible capital Given the disproportionate effect of the many states placed temporary moratoria expenditures. Recipients seeking to use pandemic on people of color,home on children aging out of the foster care funds for capital expenditures should visits are an essential equity tool that system.148 As these temporary moratoria refer to the section Capital Expenditures tackle mayor negative effects of the expire,additional support will be in General Provisions: Other for pandemic.These are dust a few needed to assist children exiting the additional eligibility standards that selections from the evidence that apply to uses of funds for capital suggests many home visiting models can system. expenditures. have a positive effect on maternal Additionally,financial and material Public Comment:Home Visiting: physical and mental health.145 hardship are causal factors in the Treasury has also received questions Treasury Response:Home Visiting: increase of new children entering the about whether the provision of home Given the widespread impact of foster care system,whether through loss visiting services would be responsive to of a caregiver, domestic violence,149 or the health and mental health needs of 140Id. other associated costs of the pandemic. impacted new mothers, citing the 141 Sarah Javaid,Sarah Barringer,Sarah D Therefore, support to decrease these positive mental health impacts shown Compton,Elizabeth Kaselitz,Maria Muzik,Cheryl hardships will support families and A.Moyer,The impact of COVID-19 on prenatal increase positive outcomes for youth on the mother as well as improved care in the United States:Qualitative analysis from p outcomes for children. a survey of 2519 pregnant women,Midwifery, Background:Home Visiting:Pregnant Volume 98,2021,102991,ISSN 0266-6138,https:// 146National Conference of State Legislatures, and recently pregnant individuals are at doi.org/10.1016/J.midw.2021.102991. Criminal Justice System Responses to COVID-19 142 A Basu,HH Kim,R Basaldua,KW Choi,L (November 16,2020),https://www.ncsl.orgl an increased risk for serious illness from Charron,et al.,A cross-national study of factors research/civil-and-criminal justice%riminal justice- COVID-19.139 Furthermore,pregnant associated with women's perinatal mental health and-covid-19.aspx. individuals with COVID-19 are more and wellbeing during the COVID-19 pandemic, 147 John Burton Advocates for Youth,The likely to experience preterm birth PLOS ONE 16(4):e0249780,(2021),https://doi.orgl Cumulative Impact of the Pandemic on Youth Who (delivering the baby earlier than 37 10.1371/journal.pone.0249780. Have Been in Foster Care or Homeless(May 2020) 143 Amanda Taub,A New Covid-19 Crisis: https://jbay.org/wp-content/uploads/2021/O4/JBAY- Domestic Abuse Rises Worldwide,New York Times COVID-19-Impact.pdf. among early-grade public school students, (April 6,2020),https://www.nytimes.com/202O/O4/ 148 John Kelly,Next Week,Thousands of Foster Brookings Institution(February 22,2021),https:// 06/world/coronavirus-domestic-violence.html. Youth Will Age Out on the Same Day(September www.brookings.edu/blog/brown-center-chalkboard/ 144Xenia Shih Bion,Efforts to Reduce Black 21,2021),https://imprintnews.org/subscriber- 2021/02/22/understanding-covid-19-era- Maternal Mortality Complicated by COVID-19, content/thousands-of-foster-youth-will-age-out-on- enrollment-drops-among-early-grade-public-school- California Health Care Foundation(April 20,2020), the-same-day/59006. students/. https://www.chcf.org/blog/efforts-reduce-black- 149 Conrad-Hiebner,Aislinn,and Elizabeth 139 Centers for Disease Control and Prevention, maternal-mortality-complicated-covid-19/. Byram,The Temporal Impact of Economic Pregnant and Recently Pregnant People,https:// 145 U.S.Department of Health and Human Insecurity on Child Maltreatment:A Systematic www.cdc.gov/coronavirus/2019-ncov/need-extra- Services,Home Visiting Evidence of Effectiveness, Review.Trauma,Violence,&Abuse,vol.21,no.1, precautions/pregnant-people.html(last visited https://homvee.acf.hhs.gov/outcomes/maternal%20 Jan.2020,pp.157-178,doi:10.1177/ November 9,2021). hea1th/In%20Brief. 1524838018756122.