December 4, 2015
Volume XXXIX No. 35
 In This Issue

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Thank you for reading This Week in Washington. In each issue you will find summaries of relevant events and APHSA's analysis behind them. More simply, you will learn about the event, whether it is a policy letter, new regulation or key appointment, and what it means to you.
Top Story
No Clear Path to Funding the Government
 
With only four legislative days left before the current continuing resolution funding the federal government expires on December 11, there remains no clear path to passage of an omnibus appropriations bill. 
 
An omnibus appropriations bill developed by House and Senate Republicans was rejected by Democrats and called "a non-starter" by House Minority Leader Nancy Pelosi (D-CA) because it is said to contain at least "30 poison pill" policy riders, which describes bill language that would result in rejection of a bill that is otherwise acceptable. In this case the riders would force the Administration to change its policies on Syrian immigrants, the environment, banks and investment companies, health care, and other programs important to the president. Even if the House and Senate passed the bill, it is certain that the president would veto the bill if it continued to include these riders.
 
Complicating the situation is the fact that the riders were added by House Speaker Paul Ryan (R-WI) and Senate Majority Leader Mitch McConnell (R-KY) and not the appropriators, themselves. In situations like this, it is much more difficult for House members and senators to negotiate a solution unless they are given permission by the leadership, which does not seem to be forthcoming.
 
Despite this, House Appropriations Chairman Hal Rogers (R-KY) remains optimistic that he and others on the House Appropriations Committee will be able to draft a bi-partisan omnibus appropriations bill that can pass the House and Senate and the president will sign.   
 
Failure to pass an omnibus appropriations bill that would fund the federal government through the end of fiscal year 2016 (September 30) would result in a government shutdown.
 
The American Public Human Services Association (APHSA) will continue to keep its members informed about the appropriations process and what it may mean for state and local health and human services agencies.
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Senate Finance Moves Closer on Child Welfare Finance Legislation

In the Nov. 20 edition of TWIW, the American Public Human Services Association (APHSA) alerted the membership that Senator's Orrin Hatch (R-UT) and Ron Wyden (D-OR) had reached a bipartisan agreement on child welfare reform legislation. Since then, the Senate Finance Committee has released a summary of the proposed Chairman's Mark of the Family First Act. The chairman's mark is the legislative proposal that Finance Committee Chairman Hatch will present as soon as the committee is ready to review the bill.

The Senate Finance Committee presented an overview of the proposal in a meeting held on November 23. Following that meeting, the committee released a summary document, but not the complete bill language, which will be released 48 hours before the committee's review.

The Family First Act proposes to expand federal funding for prevention services and outline federal policies for authorized out-of-home (foster care) placements or placement settings. States would be allowed to draw down federal financial support for mental health, substance abuse prevention, and in-home parenting skills programs for children deemed candidates for foster care, those at imminent risk of entering or re-entering foster care, without concern for income eligibility. In addition, reimbursement would be allowed for up to 12 months for children, parents or kinship caregivers when the services are tied to evidence-based programs through a tiered, phased-in approach. Other changes include:
  • A new short-term crisis intervention program from mandatory Title IV-B funding to provide additional assistance; and
  • Case plan requirements to identify and tie prevention services to a child's permanency goal.
 
The committee will also consider measures aimed at reducing the use of congregate care settings, encouraging placement in the most family-like settings, and ensuring non family-based care provides necessary therapeutic interventions. Some of the provisions to achieve these goals are:
  • Authorizing federal reimbursement for specified settings (foster family homes, defined in the proposal, qualified residential treatment programs, facilities for pregnant or teens, and clinically recognized treatment program);
  • Requiring assessments are completed in 30 days after placement in a QRTP and within 60 days after a court reviews the appropriateness of placement;
  • Enhancing requirements for QRTP placements including who conducts the assessment, what the assessment includes, and the team of individuals participating in the assessment; and
  • Enhanced requirements also include notification of the private right to action for youth 13 and older in QRPT for 12 consecutive months/18 nonconsecutive months and for youth under age 13, at the six month mark.
 
APHSA is working through our Triad Partnership, the National Association of Public Child Welfare Administrators (NAPCWA) affiliate, the committee staff, and our public and private member and stakeholder networks to inform development of the draft legislation.

We appreciate Senators Hatch and Wyden's leadership on this issue. Once the bill is introduced and we've reviewed the legislative text, we will share our insights with you and continue our work to ensure the measures align with our overall principles and minimize unintended consequences for public systems.

We encourage you to visit the NAPCWA website for updates on these activities.
OIG Releases Semiannual Report to Congress on Health and Human Service Programs

On November 30, 2015 the Department of Health and Human Services (HHS) Office of Inspector General (OIG) released its Semiannual Report to Congress for the six-month period that ended September 30, 2015.

OIG's program integrity and oversight activities are shaped by legislative and budgetary requirements pursuant to the Inspector General Act of 1978 and are targeted to promote economy, efficiency, and effectiveness in the programs and operations of HHS.

OIG conducts program integrity and enforcement activities on the over 100 public health and human services programs to determine compliance with the Improper Payments Information Act of 2002 (IPIA) as amended by the Improper Payments Elimination and Recovery Act of 2010 (IPIA). In addition, under the Disaster Relief Appropriations Act, all programs receiving related funds must report and calculate an improper payment estimate.
In this newly released report OIG found that HHS followed guidance, "and in general, the methodologies used by HHS to estimate improper payments were reasonable and valid, resulting in reasonable estimates. HHS also reported information on its efforts to recapture improper payments and the results of those actions."

"However, HHS did not fully comply with several IPIA requirements in that it did not perform some risk assessments of payments; did not publish an improper payment estimate for the Temporary Assistance for Needy Families (TANF) program; did not publish corrective action plans for TANF; did not meet improper payment rate reduction targets for four of the six programs for which it reported reduction targets in the FY 2013 AFR (Medicare Fee-for-Service [FFS], Medicaid, Foster Care, and Child Care Development Fund); and did not report an improper payment rate of less than 10 percent for one of the eight programs deemed susceptible to improper payments (Medicare FFS) and two of the seven programs deemed susceptible to improper payments under the Disaster Relief Appropriations Act (Administration for Children and Families Social Services Block Grants and Substance Abuse and Mental Health Services Administration Grants). In addition, HHS has not been in compliance with the IPIA for four consecutive FYs for TANF and three consecutive FYs for Medicare FFS."

In response, HHS announced that it intends to
fully address all OIG "recommendations from prior years, including the need to provide an improper payment estimate for TANF, meet improper payment rate reduction targets, and reduce improper payment error rates to below 10 percent" and "address a new requirement under OMB's guidance, to conduct risk assessments of payments to employees and charge card payments as part of its risk assessment process for 2015."


The Administration for Children and Families' (ACF) Information and Technology (IT) infrastructure was reviewed and found vulnerable cyberattacks in two primary areas: selected external web applications and wireless networks. ACF's information technology investments include systems that support operations for grants management, child support enforcement, foster care and adoption programs, and Head Start programs. See the Department of Health and Human Services Office of Inspector General Penetration Test of the Administration for child and Families' Computer Networks and External Web Applicationsreport completed in September 2015.

This report summarized OIG recommendations. Because of the sensitive nature of the information discussed, this report does not include the detailed recommendations that were provided directly to ACF. The administration concurred with all of OIG recommendations. ACF and OIG recognize that individual vulnerabilities may also signal systemic issues in a program or across multiple programs.
Resources
FNS Issues Guidance on SNAP ABAWDs

On November 19, the U. S. Department of Agriculture, Food and Nutrition Service (FNS) distributed a memorandum guiding states on the implementation of policy applicable to able-bodied adults without dependents (ABAWDs) who are receiving Supplemental Nutrition Assistance Program (SNAP) benefits.

ABAWDs are subject not just to work-seeking requirements but also to restrictions on their SNAP participation should they not be successful. This population is uniquely limited to three months SNAP participation in a 36 month period unless they participate in a work program (that may be actual work) for 80 hours per month or take part in workfare. The restriction applies whether or not they are offered employment-related services by their SNAP office.  

The policy carries complex administrative responsibilities for states, including the risk of incorrect issuances that may cost them payment errors. States have been largely free of these responsibilities because of waivers widely granted since the 2008 economic downturn. Many of the waivers will expire in 2016, so month-to-month tracking of SNAP participation by ABAWDs will now be necessary. The FNS memo covers the gamut of policy nuances and state responsibilities.

News Clips
Child Care/Child Abuse  
 
 
 
 
 
 
Adoption & Foster Care
 
 
 
 
Health and Mental Health Care
 
 
 
 
Medicare/Medicaid
 
 
 
    
 
SNAP/Food Stamps
 
 
TANF
 

Amer. Public Human Servics Assoc. Newsletter