On May 28, the Senate Health, Education, and Pensions Committee released draft bill language on the reauthorization of the Child Abuse Prevention and Treatment Act. The bill contains several changes to the grants available to states to operate child protection services, including a focus on differential response models and working collaboratively with domestic violence services agencies. Most notably, the bill would change the way the federal government allocates state grant funds. Currently, states receive money based on the amount of children in their state under age 18; the draft bill would make an across-the-board amount to each state and the remainder would be distributed based on child population. Each state would receive at least $50,000 to operate its programs; if Congress appropriated additional resources, that amount would increase.
In current law, states must assure and certify several policy and practice issues, including having a child fatality review board and releasing information on child deaths to the appropriate authorities. Two new assurances have been added to the 23 that currently exist: the bill requires states to certify that programs and training address the needs of unaccompanied homeless youth, and states must collaborate with community-based prevention agencies and families affected by child abuse or neglect to develop their state plan.
The bill would change the reporting of caseworkers responsible for intake and screening to include assessment and investigation of reports. Reports must also include the average caseload of caseworkers involved in intake, screening, assessment, and investigation. The state must provide information on state required education and training of personnel, demographic information of all caseworkers involved, and caseload requirements. The committee plans to mark up the bill at the end of June. The House has yet to act during this Congress.
For a review copy of the draft language, contact Courteney Holden at APHSA at Courteney.Holden@aphsa.org or (202) 682-0100, ext. 249.
Congressional leaders hope to complete work on all 12 fiscal year 2010 appropriations bills before the end of the current fiscal year, Sept. 30, and thus avoiding an omnibus spending bill. If Congress succeeds, it will be the first time the bills have been completed on schedule since 2005. House leaders have set a goal of passing all the bills before the August recess. Senate Majority Leader Harry Reid (D-Nev.) said he hopes to see the Senate clear some appropriations bills before July 4. Markups of spending bills have not yet been scheduled, although House subcommittee markups could start shortly. The Senate Health, Education, Labor and Pensions Committee is moving toward a possible start of markup sessions in mid-June. Senate Republicans have publicly expressed a desire for a slower process than the White House or Democratic Senate leaders have outlined. Meanwhile, Democratic leaders hope to use their majority to expedite the appropriations process. Congress passed a budget resolution this past April 29, setting broad outlines for FY 2010 total spending; see This Week, May 1.
President Obama and Congressional Democrats have prioritized a proposed health care overhaul that they say will reduce costs and provide universal coverage. Congressional leaders have said they hope to complete work on health care legislation before the August recess. In a meeting with Senate Democrats on June 2, the president set a timeline that would result in his signing the bill by October. He urged members of Congress to settle their differences on issues such as a public plan option. Those differences were highlighted on June 4, when the House “Blue Dog” coalition of moderate Democrats released a proposal for a public plan that would operate like a private insurance plan. Most liberals favor a public plan option that would work like Medicare. Obama and other Democrats, such as Senate Finance Committee Max Baucus (D-Mont.), recognize that the presence of a public plan option would reduce the likelihood of bipartisan support, another priority for the administration. Baucus met with the president last week to discuss taxing a portion of health care benefits provided by employers, another major point of contention in the health care reform debate. Baucus is in favor of taxing employers, while Obama campaigned against the issue. Baucus is one of the main architects of the bill along with Sen. Edward M. Kennedy (D-Mass.), chairman of the HELP Committee and proponent of a public insurance option.
On June 3, President Obama sent a letter to Sens. Kennedy and Baucus indicating his support for a public plan option as well as a mandate that everyone buy insurance. In his letter, Obama called for a “hardship waiver” that would exempt some low-income individuals from any mandate to purchase insurance. The president also endorsed a proposal by Sen. John Rockefeller (D-W.Va.) that would shift the responsibility of setting Medicare payment rates from Congress to MedPAC, an independent board. Baucus said this week that he remains optimistic that his and Kennedy’s committees could forge a compromise bill that will go before the full Senate before the August recess.
Another potential trouble spot is the wait for cost analyses from the Congressional Budget Office, which will reveal the cost of health care legislation to taxpayers. The CBO must consider the variety of proposals for reforming the health care system in its analysis, which could include thousands of potential combinations of factors. Because this could be a lengthy process, Republicans and some Democrats object to the goal set by Baucus to vote on a bill this month. Sen. Pat Roberts (R-Kan.) said a rushed deadline would make it less likely that the bill would enjoy bipartisan support.
House Democrats hope to pass a bill before the August recess that would put into law the “pay-as-you-go” (PAYGO) rule, which requires the cost of new mandatory spending or tax cuts to be offset by equivalent spending savings. President Obama and House leaders want to restore the rule in part to answer concerns of the moderate House Democrats. Lawmakers are waiting for the White House to finalize a legislative proposal, which may be ready this month, before taking action. The proposed plan is likely to be similar to past law in which a “scorecard” recorded how much Congress was adding to the deficit each year. If there was a negative balance, automatic cuts were made so the deficit would not grow. Democrats implemented the PAYGO rule in 2007, but it has been waived several times and the deficit is growing, partly due to congressional response to the economic crisis. President Obama and House Democrats believe that giving the rule the force of law will make it stronger. Senate Democrats have signaled reluctance to put PAYGO into law, in part because the White House Office of Management and Budget would manage the scorecard.
On May 28, the Department of Health and Human Services Office of Inspector General announced the results of its first completed audit related to HHS funds provided under the American Recovery and Reinvestment Act. The audit found that HHS correctly calculated temporary increases in Medicaid’s Federal Medical Assistance Percentages in accordance with ARRA requirements. The federal government pays its share of state Medicaid costs based on HHS’ FMAP calculations. The FMAP amounts vary, depending on each state’s relative per-capita income. OIG found that HHS properly calculated the ARRA FMAP increases for the 50 states and the District of Columbia for the first two quarters of fiscal year 2009. Because the audit found no discrepancies, OIG made no recommendations to HHS. ARRA provides $87 billion in additional Medicaid funding based on temporary increases in states’ FMAPs for the period October 1, 2008, through December 31, 2010. The full report is at http://oig.hhs.gov/oas/reports/region9/90900075.pdf.
On June 2, the Kaiser Family Foundation issued a report indicating that that Social Security and Medicare trustees project no cost-of-living adjustment to Social Security benefits in 2010 and 2011, and only a small one in 2012. As a result, millions of Medicare beneficiaries may face reduced Social Security benefits due to an increase in Medicare premiums in the next two years. The COLA adjustment is pegged to inflation, and the recession has eliminated increases in this index. With no COLA, beneficiaries will be affected by sharp increases in monthly premiums for Medicare Part B coverage. Over the next two years, Part B premiums will increase in accordance with a law that requires premiums to cover 25 percent of program costs. Part B pays for doctor bills and other outpatient costs, and the monthly premiums that seniors pay are deducted from their Social Security benefits. Therefore, as Part B premiums rise, beneficiaries will see their Social Security benefits reduced. A “hold harmless” clause protects 75 percent of beneficiaries from an increase in their premiums when there is no COLA, or when it falls below the increase in the monthly Part B premium. As such, new Social Security enrollees are the first group to be affected by these increases. In addition, Medicare Part D premiums may increase over the next two or three years, which will affect all beneficiaries who pay monthly premiums. Part D is the prescription drug coverage component of the Medicare program. More details are available at http://www.kff.org/medicare/7912.cfm.
On May 26, Department of Agriculture Secretary Tom Vilsack appointed Max Finberg as director of Faith-Based and Neighborhood Partnerships at the department. Finberg has worked in a number of anti-hunger positions, including most recently as director of the Alliance to End Hunger. He has also served as special assistant to the ambassador at the U.S. Mission to the UN Agencies for Food and Agriculture in Rome, Italy. Finberg was also a senior legislative assistant to former Rep. Tony Hall (D-Ohio) and worked on the successful passage of the Hunger Relief Act and the Community Solutions Act with a variety of anti-poverty and faith-based organizations. He is also the founding director of the Mickey Leland/Bill Emerson Hunger Fellows Program at the Congressional Hunger Center.
On May 27, the Food and Nutrition Service released a policy memo regarding use of federal employment and training grant and matching funds for educational components in the Supplemental Nutrition Assistance Program. FNS emphasized that where federal funds, whether 100 percent or those that are nominally reimbursed at 50 percent, are made available to operate an approved educational component, these funds cannot be used to supplant non-federal funds being used for existing services and activities. The state agency may use federal funds to operate its approved education component to the extent that the employment and training component costs exceed the normal cost of services provided to students not participating in E&T. The memo was issued to all state agencies via the FNS Partnerweb system. It is not yet posted on the FNS public web site.
The HHS Office of Community Services held a webinar on June 4 on the state, local and tribal government Capacity Building Program. The webinar was recorded and will be available at http://www.acf.hhs.gov/programs/ocs/scf/index.html.
This Week in Washington is published by the American Public Human Services Association each week Congress is in session and on other dates. Editors: Larry Goolsby and Frank Solomon. Writers: Jodie Anthony (health), Rashida Brown (child welfare), Ilana Cohen (health), Robert Ek (TANF, child support), Sue Hall (SNAP), Courteney Holden (child and family services), Katherine Klosek (budget and appropriations), Bertha Levin (child and family services), Ngozi Onunaku (child care), Nanette Relave (health), Damon Terzaghi (health), Emily Wengrovius (legislative affairs), and Angela You (child and family services).