Sen. Charlane Oliver in 2024
Of Sen. Charlane Oliver’s slate of three child care-related bills, one is left standing after a Senate Health and Welfare Committee meeting Wednesday.
Two bills aimed at the Department of Human Services’ Smart Steps child care voucher program, which subsidizes the cost of care for low-income families, met their demise. Senate Bill 2207 would have reduced or eliminated copays for those making less than 150 percent of the federal poverty level and capped fees at 7 percent of household income for families above the federal poverty line.
Another bill (SB2064/HB2233) would have allowed more families into the program, increasing the income ceiling to 100 percent of the state median income from 85 percent. It failed but did garner some bipartisan support, with Sen. Becky Massey (R-Knoxville) and Sen. Rusty Crowe (R-Johnson City) voting in favor.
Oliver and DHS were asked by chairperson Crowe to have a discussion outside the committee about SB1805/HB1962, which would require DHS to recalculate its reimbursement amounts for Smart Steps based on a cost estimation model rather than the current market rate model.
Area child care providers testified that the state’s voucher program falls short of the amount needed to keep such centers running and properly staffed.
Glen Leven Day School executive director Debbie Ferguson testified that 10 of her 26 employees had resigned over the past two years. As pandemic funds dry up, the school has raised tuition to account for higher costs for newly required DHS training, offering staff a living wage and benefits, and other expenses.
“I appreciate you considering this opportunity to find relief for parents,” Ferguson said. "They're really stressed about how they're going to pay the bills, and we have no choice but to roll those costs over.”
Looking at scarcity, cost burden and workforce issues — and how the state will try to dig out of it
DHS representatives testified against the bill, expressing concern that private payers, those who aren’t on the certificate program, would be pushed out of care if the reimbursement is too high.
“The [market rate] model looks at the cost for the parent,” Oliver explained. “That cost is driven a lot by what the private provider charges. This [cost estimation] model looks at the cost for the provider and how much it takes to run the operation. The difference is the market rate study asks the providers what they are currently charging, so it is a look back and takes historical data. It does not take into account current market fluctuations, inflation, all of the things it takes to run a day care.”
Another bill (SB2063/HB2232) is also still making its way through the legislature, but was rolled two weeks on Wednesday. It would create a pilot program to study wages for child care workers.
Oliver is also proposing a new tax on transpotainment vehicles that would create a state fund to match local government funding for early childhood care. That bill (SB1907/HB2517) has yet to be heard in committee.
Also on Wednesday, Rep. Aftyn Behn (D-Nashville) saw her first bill as a legislator (HB1669/SB1759) move forward in the House Health Committee. It would require a child care agency to inform parents at least 60 days before it closes.
An appeal by Sen. London Lamar (D-Memphis) to have automatic enrollment for children in TennCare also failed Wednesday. In Tennessee, about 4.5 percent of children are uninsured, according to Vanderbilt University’s latest report.
Lamar would like to get that number to zero, with eligible children enrolled automatically and without yearly redetermination unless the child dies or moves out of the state, the enrollment was in error, the parent chooses to opt out, or the state learns that the family's income is too high to qualify.
TennCare representatives submitted a fiscal note of $15 million, but did not express an opinion on the bill. Out of the cost, the federal government would pay $10 million.
“TennCare returned over several hundred million dollars back to the general fund for last year's budget,” Lamar said. “It's not a question of, 'Do we have the money?' It's more a question of, 'All the children who are eligible to get our health care, do we want to allow them to do that?' So many children are losing health care coverage due to simple paperwork issues. That is what we're trying to solve, is to fill that gap.”
Hundreds of thousands of Tennesseans have been dropped from TennCare’s roll this year as part of the first redetermination process since 2020. The majority were due to clerical errors, regardless of eligibility.
This article was first published by our sister publication, the Nashville Post.
