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2015 Highlights
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This edition will be 2015's final This Week in Washington. We have compiled our year-end highlights looking back on some of our successes and updates from 2015. TWIW will resume publication Jan. 8 with a new look.
Happy Holidays from APHSA!
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Congress Agrees to $1.1 Trillion in Spending and $700 Billion in Tax Breaks
After months of wrangling and political posturing, the House and Senate today passed an omnibus appropriations bill that funds the federal government through September 30, 2016. The omnibus, as it is commonly referred to, consolidates all 12 appropriations bills into a single bill, and, in this case, includes intelligence and cybersecurity authorization bills.
The omnibus includes billions of dollars in new spending for health and human services programs, including more than$2 billion in increased funding for the National Institutes of Health. Other "winners" include:
- Title IV-E of the Social Security Act which is authorized to spend $5.3 billion, an increase of $500 million over fiscal year 2015;
- The Child Care and Development Block Grant Act which is authorized to spend $2.8 billion, an increase of $400 million;
- Head Start and Early Head Start which is authorized at $9.2 billion or $600 million over fiscal year 2015 funding; and
- Child support enforcement which is authorized to spend $3 billion in fiscal year 2015, an increase of $500 million.
Most Health and Human Services programs, however, received either a very small increase or were level funded. These include:
- Temporary Assistance for Needy Families (TANF) at $16.5 billion;
- TANF state contingency funds at $608 billion, $573 million of which may be used for a new Pathways to Jobs initiative. It would support states' efforts to provide work opportunities to low income individuals through subsidized employment;
- Social Services Block Grant at $1.7 billion;
- Low Income Home Energy Assistance at $3.4 billion;
- Ryan White HIV/AIDS Program at $2.3 billion including up to $900 million for State AIDS Drug Assistance Programs;
- Sexually transmitted disease prevention at $1.1 billion;
- Mental health services at $1.1 billion;
- Substance abuse treatment and prevention at $2.1 billion;
- Human trafficking and torture victims relief at $1.7 billion;
- Rural health initiatives at $150 million; and
- Voluntary family planning at $287 million.
Most, if not all, of the contentious policy riders were eliminated, including one that would have prevented Syrian refugees from being resettled in the U.S., and another that would have eliminated funding for Planned Parenthood.
Congress also adopted a "tax extenders bill" that will cost $700 billion in fiscal year 2016 pushing the total cost of the appropriations and tax extenders bills to $1.7 trillion. However, the tax extenders bill makes permanent the Child Care Tax Credit, the American Opportunity Tax Credit, and the Earned Income Tax Credit, all of which benefit low-income Americans. Also made permanent are the above-the-line deduction for teachers who buy school supplies, the charitable deduction for contributions of real property used for conservation purposes, and the Research and Development Tax Credit.
Several taxes that fund the Affordable Care Act (ACA) are delayed for two years including the medical device and high cost employer-sponsored health coverage excise tax. This appears to have support from the president who has been under a lot of pressure from medical device manufacturers who feared the tax on their devices would negatively impact sales, and organized labor whose members tend to have higher priced healthcare cost.
The president is expected to sign the bill over the weekend, which means that a government shutdown over the holiday season has been avoided.
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HHS Releases CCDBG Notice of Proposed Rulemaking
The actual rule will not be published in the Federal Register until December 24, 2015, but an advance copy was made available through the National Archives.
The changes in the law, which were designed to improve the safety and quality of child care, implement family-friendly subsidy policies to promote continuity of services, and give parents the information they need to make good choices, will be the focus of this proposed rule.
Unfortunately, the NPRM has been released more than 13 months after Congress passed and the president signed into law the Child Care and Development Block Grant of 2014, at a time when many state and local child care programs have already completed their planning process.
For more information please contact: Andrew Williams, Policy Division director, Department of Health and Human Services, Administration for Children and Families, Office of Child Care, 370 L'Enfant Promenade SW., Washington, DC 20447. You may also reach him by phone: 202 401-4795, fax: 202 690-5600, or email: [email protected].
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Social Innovation Fund Survives and P3 Advances in FY16 Budget
The Social Innovation Fund (SIF) was targeted for elimination but survived the final budget deal-pending congressional vote and presidential signature-struck between Congress and the president on December 15.
While funding for the SIF was reduced from $70 million to $50 million. Funding for the Corporation of National and Community Service of which SIF is part was increased. The provisions that allow SIF to set aside up to 20 percent of its funding for pay-for-success projects were retrained. Read more about SIF here and Corporation of National and Community Service here.
Performance Pilot Projects (P3) for Disconnected Youth were also included again in the appropriations bill for Labor, Health and Human Services, Education, Department of Justice and Related Agencies. In addition, for the first time the Department of Housing and Urban Development (HUD) is included as key partners for disconnected youth. Federal agencies may use federal discretionary funds that are made available in this act to carry out up to 10 Performance Partnership.
Funds made available to Transportation, Housing and Urban Development, and Related Agenciesunder the heading ''Homeless Assistance Grants'' may be used by the Secretary to participate in P3 for fiscal year 2016 provided that such participation shall be limited to no more than 10 continuums of care and housing activities to improve outcomes for disconnected youth. Access the bill text here.
The American Public Human Services Association (APHSA) on behalf of the state and local public human services agencies we represent submitted comments in response to the Proposed Priorities, Requirements Definitions, and Selection Criteria-Performance Partnership Pilots for Disconnected
Youth notice that was issued by the Department of Education in the Federal Register of October 22, 2015. The APHSA Performance Pilots Partnerships Comments Letter is accessible here.
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APHSA Launches National Collaborative for Integration of Health and Human Services at 5
th Annual Meeting
APHSA officially announced the re-launch of the National Workgroup on Integration (NWI) to the National Collaborative for Integration of H/HS (National Collaborative) at this year's 5
th
Annual Meeting in April.
Through this change, APHSA expanded the scope and breadth of NWI to dedicate focus on the remaining elements of the APHSA Health & Human Services Business Model for the 21st Century. This model includes but is not limited to, coordinated service delivery models, different financing approaches across programs and sectors, and the development of outcome measures all critical to impacting population health and well-being outcomes. The National Collaborative will retain a parallel focus on how data sharing and systems interoperability support these efforts.
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APHSA Submits Comments on CMS' 90/10 Rule and HHS & USDA Announce 3 Year Extension to A-87 Cost Allocation Exception
In June, APHSA submitted comments on the now final rule "Medicaid Program: Mechanized Claims Processing and Information Retrieval Systems" or the "90/10 Rule" that would include Medicaid eligibility and enrollment (E&E) systems as a part of a state's mechanized claims processing and information retrieval systems ultimately allowing E&E systems to access the enhanced Federal Financial Participation rate, and would update conditions and standards for such systems.
In July, and consistent with APHSA's recommendations, the U.S. Department of Health and Human Services (HHS) and the U.S. Department of Agriculture (USDA) formally announced the three-year extension of the exception to the Office of Management and Budget's (OMB) Circular A-87 cost allocation requirements.
The extension provides state health and human services programs to continue to benefit from improvements to state Marketplaces, Medicaid, and CHIP E&E systems through December 31, 2018 and to move toward the goal of creating integrated and interoperable health and human services systems. Also consistent with APHSA's recommendations, HHS & USDA developed a new virtual H/HS Integration Community that states will be able to share Advance Planning Documents, acquisition documents, and Information Technology artifacts to further support reuse for integrated E&E.
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APHSA Submits Comments on ACF's CCWIS NPRM
In October APHSA, through participation by the state members of the National Collaborative, the National Association of Public Child Welfare Administrators (NAPCWA) affiliate and ISM, developed and submitted comments on
ACF's Comprehensive Child Welfare Information System (CCWIS) NPRM.
Generally, the NPRM would remove the requirement for a single comprehensive systems (e.g., SACWIS or SACWIS-compliant system) and allow IV-E agencies to implement systems supporting child welfare practice.
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APHSA Releases On the Road to Horizontal Integration: 2015 National Findings
In December, 2015, the National Collaborative released,
On The Road to Horizontal Integration: Results from APHSA's 2015 National Survey of Health and Human Service Agencies, which captures the aggregate findings from this year's self-assessment. The 2015 report outlines where organizations place their operations farthest in maturity and where additional work is needed toward progressing up the Human Services Value Curve. It also outlines national trends over the past two years since the initial 2013 national survey.
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N
ational Collaborative Releases
Roadmap to Capacity Building in Analytics
In December, 2015, the National Collaborative's Analytics Committee released the Roadmap to Capacity Building in Analytics, which builds upon the National Collaborative's 2014 Analytic Capability Roadmap 1.0 for Human Service Agencies by providing the analytical capabilities underpinning successful analytical efforts, defining the range of skills required as well as appropriate governance structures and change management processes, and includes practical examples of existing business solutions across the public and private health and human services sectors.
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APHSA-NAPCWA Key in Advancing National Child Welfare Policy
Working through our public human service executive and child welfare administrators and as part of our Triad Partnership for Results Based Funding in Child Welfare, the National Association of Public Child Welfare Administrators (NAPCWA) has been part of a successful movement to align federal child welfare funding with what we know works. Our efforts in this area include:
- Submitting comments letter in response to release of the Family First Act summary document. The bipartisan legislation was developed by Senator Orrin Hatch (R-UT), Chair, Senate Finance Committee and Senator Ron Wyden (D-OR), Ranking Member, Senate Finance Committee. Staff, members, and private sector partners collaborated over several months, meeting with finance committee staff to review and analyze draft legislative text, develop new policies to include in federal legislation, and test ideas and approaches for new federal investments in prevention and early intervention.
- Convened Triad National Workgroup and Strategic Advisors Group to outline a policy framework of finance and accountability recommendations and determine strategy to mobilize and influence Congress to enact child welfare finance reform legislation.
Launched Keeping Kids in Families Campaign through the Triad for Results Based Funding for Safe Children and Stronger Families. The Triad includes the American Public Human Services Association (APHSA), the Alliance for Strong Families and Communities and the National Organization of State Associations for Children. The Triad partnership has advanced concrete ideas for achieving results-based funding in child welfare with a focus on shifting investments up-stream for prevention and early intervention services.
Comments Submitted on New Federal Legislation and Proposed Regulations
- Comments submitted to the National Commission to Eliminate Child Abuse and Neglect Fatalities (CECANF) provides increased understanding of prevention and early intervention strategies, challenges and barriers to addressing abuse and neglect, and specific policy, practices, funding and regulatory changes needed to build public child welfare's capacity in child abuse and neglect fatalities. The comments underscored the importance of examining the use of child protective services, outlining best practices in preventing fatalities and identifying the effectiveness of programs targeted at preventing maltreatment and improving child safety. Addressing child maltreatment deaths requires an integrated, holistic service delivery developing and applying modern data platforms, and updating federal reporting systems.
- APHSA and its affiliate NAPCWA provided comments on Senator Wyden's (D-OR) legislative proposal, Family Stability and Kinship Act of 2015 to provide new investments for prevention and early intervention services to help children remain safely at home, and minimize the risk for entry into foster care. The legislation supports the theory that prevention and early intervention allows more children to remain safely in their homes and equips parents with services and supports to provide a nurturing environment for their children. Sen. Wyden updated draft included a number of recommendations NAPCWA included in response to the original draft including: allowing "kin" to be eligible for new IV-E funded services; adding a transition period to build capacity/implement new provisions; and reducing requirement that at least 50% of service funds be used towards evidence based practices.
- Comments provided in response to the Children's Bureau released a Notice of Proposed Rulemaking (NPRM) for the Adoption and Foster Care Analysis and Reporting System. The NPRM proposed changes to the federal reporting system as a result of the enactment of key federal laws impacting child welfare. The current NPRM addressed some of the concerns APHSA and NAPCWA shared in response to the 2008 and 2010 NPRMs, but the scope of the proposed changes will have a significant financial and workforce capacity impact. The comments emphasized that regulatory changes should promote and incentivize states to meet federal reporting requirements and observe the principles that will facilitate successful implementation of changes, with a focus on ways to continue good case practice and family engagement.
- APHSA and its affiliate, NAPCWA provided comments to the Administration on Children and Families, Children's Bureau to inform regulations for the Preventing Trafficking and Strengthening Families Act (P.L. 113-183). Members outlined the public agency's perspective on the intersection of child welfare and domestic sex trafficking, outlining the concerns that child welfare is increasingly seen as the primary responding entity to intervene on behalf of victims and laying out specific inquiries on clarification, technical assistance and resources needed to implement the provisions of the law.
- Comments provided in response to the Administration on Children, Youth and Families, Administration for Children and Families on the Title IV-E Adoption Assistance Program's Suspension and Termination Policies. The comments sought to provide guidance on agency's policies and procedures when it is learned that a child is out of the adoptive home, and the Title IV-E agency does not receive the required information to confirm continued eligibility for adoption assistance.
- Comments provided on the Child Abuse Treatment and Prevention Act confidentiality provisions. Members noted that although the schools of thoughts are varied as it pertains to confidentiality, NAPCWA leaders share ACF's commitment to helping agencies adhere to CAPTA mandates regarding sharing information about reports of child abuse and neglect.
NAPCWA Serves on Council on Accreditation Public Agency Advisory Committee
Joining COA's effort to update the current Public Agency Accreditation Standards and Program, the National Association of Public Child Welfare Administrators (NAPCWA) served on the advisory committee. The Advisory Committee will assist COA in ensuring the process integrates with and expands the agency's CQI process, serves as a vehicle to implement data-informed practices; is a means to measure system-wide success at the front-end and meets the demands of regulatory activities, including participation in the CFSRs.
APHSA-NAPCWA co-sponsored the Kempe Center's 2015 International Conference on Innovations in Family Engagement.
Earlier this year, the American Public Human Services Association (APHSA) and its affiliate National Association of Public Child Welfare Administrators (NAPCWA) co-sponsored the Kempe Center's 2015 International Conference on Innovations in Family Engagement.
The event focused on family group decision making, family engagement, and differential response and sought to illustrate coordinating family meetings and designing differential response systems.
Sessions allowed participants to build practice skills and knowledge (with a focus on marginalized populations); developing and sustaining the workforce; family engagement beyond child welfare; and international research and evaluations about family engagement practices and policies and implementing differential response.
NAPCWA Serves on Council on Accreditation Public Agency Advisory Committee
,
oining COA's effort to update the current Public Agency Accreditation Standards and Program. The Advisory Committee will assist COA in ensuring the process integrates with and expands the agency's CQI process, serves as a vehicle to implement data-informed practices; is a means to measure system-wide success at the front-end and meets the demands of regulatory activities, including participation in the CFSRs.
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The American Public Human Services Associations (APHSA) and its member agencies continued their active engagement in the Supplemental Nutrition Assistance Program (SNAP) during 2015.
During the year, the House Agriculture Committee held a number of hearings on SNAP designed to educate committee members on various aspects of the program and how well they were functioning. Specific hearing topics included the role of nonprofits in supplementing SNAP assistance; potential duplication with other federal nutrition programs; SNAP's role in helping program participants move up the economic ladder and the status of SNAP work requirements; and the program's contribution to helping break the cycle of poverty.
APHSA has discussed its policy proposals for SNAP with congressional staff, and two staff members from the House Agriculture Committee attended the 2015 annual conference of APHSA's affiliate the American Association of SNAP Directors (AASD). Committee staff have indicated that the House plans to continue SNAP hearings in 2016 and to use the information gathered during them to begin drafting legislative changes for the program's next reauthorization.
In July, APHSA executive director Tracy Wareing Evans testified before the National Commission on Hunger. The commission, created by Congress through the 2014 farm bill, hosted a series of public hearings around the country under the title of "How to Ensure Americans Have Access to Sufficient, Healthy Food."
Testimony presented at the hearing will inform the commission's recommendations to Congress and the U.S. Department of Agriculture (USDA). Wareing Evans highlighted the need for a comprehensive and integrated set of policies and strategies for strengthening the nutrition, capacity, and overall well-being of low-income children, adults and families. She also urged that SNAP and other human services programs must have the means to adopt up-to-date technology, address certain populations with special access issues, modernize customer engagement models, align more seamlessly across program lines, and vigorously test innovative approaches that support these goals.
In late September, USDA Under Secretary Kevin Concannon sent a letter to the CEOs of state agencies that administer SNAP expressing concern over the quality control (QC) processes states have in place to review sampled SNAP cases and report their payment errors. A similar October report by the USDA Office of Inspector General also questioned the use by states of outside vendors and/or internal QC review committees to mitigate errors by uncovering data and circumstances that can lower the error initially found in a reviewed case. APHSA is in active discussions with FNS over this issue and how to address the questions that were raised.
In October, APHSA submitted comments to FNS on a June 23 Request for Information (RFI) that asked for suggestions from stakeholders on ways electronic benefit transfer (EBT) systems can be updated to stimulate increased competition among vendors, and to be more accessible to new users. In part the request came because of withdrawal from the marketplace of one of the three existing contractors providing EBT services. The letter reflected input from APHSA affiliates AASD and IT Solutions Management for Human Services (ISM).
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During 2015 the American Public Human Services Association (APHSA) and its member agencies continued dynamic engagement in the Temporary Assistance for Needy Families (TANF) program. The House Ways and Means Human Resources Subcommittee released a discussion draft on TANF reauthorization and held a number of hearings on the draft.
Comments to the Committee, by APHSA and others, recommended ideas for improvement by modernizing TANF's outdated incentive and accountability structure. Among the recommendations from the hearing witnesses, including APHSA Executive Director Tracy Wareing Evans, were to begin by aligning the current Work Participation Rate (WPR) structure with the workforce measurement structure defined in the Workforce Innovation and Opportunities Act (WIOA).
In July, APHSA sent a joint comment letter for the hearing record on the discussion draft. The letter, as well as Wareing Evan's oral comments, are available on the APHSA website. This work will continue into 2016.
APHSA has defined and discussed policy proposals for TANF reauthorization in partnership with state and local member agencies. In addition, discussions have been held with, among others, congressional staff, the National Governors Association, and staff of the Administration for Children and Families (ACF). APHSA will continue exploration of TANF reauthorization and alternative outcome measures in collaboration with a national workgroup of members from states and localities led by the National Association of State TANF Administrators (NASTA). House Committee staff have indicated that the House plans to continue to look at TANF in 2016 and to use the information gathered to begin drafting legislative changes for the program's next reauthorization.
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