On March 17, the Senate voted to pass a new stopgap continuing resolution, H.J. Res. 48, which will keep the government funded through April 8. The budget measure, which the House approved on March 15, replaces the previous CR that expired March 18. As requested by the House, the new CR cuts discretionary spending by another $6 billion, or $2 billion per week of the new bill’ s duration. Lawmakers on both sides of the aisle have expressed impatience with the series of CRs and are pressing a final fiscal year 2011 spending measure once Congress reconvenes after a one-week constituent work week break next week.
On March 17, the House Appropriations Subcommittee on Labor, Health and Human Services, Education and Related Agencies held a hearing on improper payments in the Medicare and Medicaid programs. Daniel Levinson, inspector general for the Department of Health and Human Services, provided testimony that focused primarily on the issues and recommendations to measure improper payments and to prevent, detect and recoup wasteful payments in the two programs. Levinson outlined several recommendations that echoed recommendations provided last week by Kathleen King, director of health care with the Government Accountability Office, at a hearing of the Senate Homeland Security and Governmental Affairs Subcommittee on Federal Financial Management. He proposed that the Centers for Medicare and Medicaid should reduce improper payments by improving controls, educating providers and clarifying guidance on documentation requirements; ensuring claims are paid appropriately, including conducting pre-payment and post-payment medical review; educate hospice providers about coverage requirements, provide tools to hospice providers, and use targeted medical reviews and other oversight to improve compliance; work with states to ensure they verify personal care attendants’ qualifications; and implement various payment edits by CMS contractors. Levinson’ s testimony is available at http://oig.hhs.gov/testimony/docs/2011/levinson_testimony_03172011.pdf.
On March 15, Sen. Burr (R-N.C.) introduced the Child Care Protection Act of 2011 (S. 581), which would amend the Child Care and Development Block Grant to require criminal background checks for child care providers. States would need to have in effect "requirements, policies, and procedures to require and conduct criminal background checks for child care staff members (including prospective child care staff members) of child care providers," and regulations to prohibit the employment of any child care staff members found ineligible as described in the bill. States would have to comply not later than the last day of the second full fiscal year after the date of enactment. The secretary of HHS could grant a state an extension of time of not more than one fiscal year.
On March 17, Rep. Jim Jordan (R-Ohio), Rep. Tim Scott (R-S.C.), and Rep. Scott Garrett (R-N.J.) announced the Welfare Reform Act of 2011. Jordan and Garrett are the chair and spending task force chair, respectively, of the Republican Study Committee. The proposed legislation would add requirements to the Supplemental Nutrition Assistance Program that resemble those in the Temporary Assistance for Needy Families program by requiring able-bodied adult beneficiaries to work or prepare for a job. The bill would also mandate that all federal, state and local public assistance expenditures be reported in the president’ s annual budget. The measure would also require that once unemployment falls to 6.5 percent, the next federal budget developed must reduce welfare spending to 2007 levels and thereafter grow with inflation. More details are posted at http://rsc.jordan.house.gov/News/DocumentSingle.aspx?DocumentID=229825.
Sen. Robert Casey (D-Pa.) has introduced the Supporting State Systems of Early Learning Act, S. 470, which would establish an Early Learning Challenge Fund to help states build and strengthen systems of early learning. According to Casey’ s office, the measure would help states raise the bar on program quality, improve workforce qualifications, and create a seamless system of early care and learning that working families and children can rely upon; make funds available on a competitive basis to states that have demonstrated the greatest progress in establishing a system of high-quality early learning; give priority to states that establish public-private partnerships and that leverage federal child care funds for the purposes of the act; and require that states provide a matching rate of 15 percent and an assurance that new funding will supplement and not supplant current funding used to support early learning programs. More details are available at http://casey.senate.gov/newsroom/press/release/?id=63d1e85f-e3db-4ad5-9b4a-23afad9b6142.
On March 17, APHSA hosted a conference call with states and staff from the Food and Nutrition Service to discuss questions and concerns raised by Section 241 of the Healthy, Hunger-Free Kids Act of 2010 (P.L. 111-296). The law, which reauthorized child nutrition programs, and that was enacted last December, revises the funding formula for SNAP education activities (SNAP-Ed), under which states provide nutrition education services to SNAP clients. In contrast to the previous open-ended match structure, grants are now allocated to states based on their 2009 SNAP-Ed expenditures and do not require state matching funds. Replacement of the previous SNAP-Ed uncapped federal match of state spending has meant funding increases for some states compared with their previously approved FY 2011 plans while others have sustained reductions, some of them dramatic. Those with reductions received notification of the cuts, which were retroactive to Oct. 1, 2010, well into this fiscal year. Several of these states described severe cutbacks in their SNAP-Ed activities, saying that the effects have been especially difficult to manage since they came in the middle of the fiscal year. Several states have had significant staff layoffs, and some states’ SNAP-Ed programs have been essentially shut down. Funding will rebound to various degrees beginning in FY 2012, but a number of the affected states anticipate difficulty restoring terminated contracts with providers and with rehiring staff who have had to be laid off.
On March 14, FNS issued a memorandum responding to several questions raised earlier by states on this issue. In the memo, FNS clarifies the meaning of the two-year performance period specified by the law for expenditure of grant funding. No documentation of the state match is necessary, even for the portion of FY 2011 prior to passage of the bill. A state may surrender unused funding, but that amount will reduce its allocation for the following year. States must submit informal plan amendments for the changes in their FY 2011 SNAP-Ed plans caused by the funding change. In FY 2014, 10 percent of the grant allocations will be based on each state’ s proportion of overall SNAP participation, a percentage that will rise in increments to 50 percent in 2018. The memo is posted at http://www.fns.usda.gov/snap/rules/Memo/2011/HHF_Act_2010_Clarifi_Sec_241.pdf.
On March 15, the Medicaid and Children’ s Health Insurance Program Payment and Access Commission submitted its annual "Report to the Congress on Medicaid and CHIP." The report provides an overview of the programs; introduced MACStats, which provides information and data on states’ respective programs; and provides an initial examination of access and payment issues impacting Medicaid and CHIP. MACPAC was established through the Children’ s Health Insurance Program Reauthorization Act of 2009 and amended through the Affordable Care Act. The complete report is available at http://www.macpac.gov/reports.
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 Amy Plotnick. Writers: Rashida Brown (child care and child welfare), Robert Ek (TANF and child support), Megan Lape (health), Bertha Levin (children and family services), Anita Light (children and family services), Nanette Relave (health), Alex Tenaglio (legislative intern), Gary Terpstra (SNAP), and Jessica Wiecezak (health).