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January
13, 2012 | Vol.
XXXIII | No.
2
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 Top Story
White
House Announces Changes at OMB and Domestic Policy Council
On January 9,
President Obama announced that Jack Lew will be leaving his post as
director of the Office of Management and Budget (OMB) to replace
William Daley as Obama's chief of staff. Lew will stay at OMB long
enough to finalize the fiscal year 2013 budget proposal, which should
be submitted to Congress by February 6. The OMB director has had a high
profile in the Obama Administration with the many debates over budget
deficits and keeping the federal government funded. There are no
indications yet who Lew's successor will be; OMB Deputy Director
Heather Higginbottom will initially be in charge. The next OMB director
will be Obama's third; Lew took the OMB helm in November 2010 after the
Administration's first budget director, Peter Orszag, resigned in July
2010. Lew will also become the third OMB director to shift over to run
the White House. He previously served as the Clinton Administration's
budget director in the 1990s, when he presided over budget surpluses
for three years.
Reaction to the
announcement generally has been positive; many feel Lew will play a
central role in the often difficult negotiations with Republicans in
Congress, particularly on fiscal issues. As OMB director, Lew has been
working closely with Congress on a host of budget-related issues.
Senate Majority Leader Harry Reid (D-NV) is known for wanting the White
House to be more involved in negotiations and is expected to welcome
Lew's appointment. Lew already has strong working relationships with
many of the Senate's top appropriators. Reid and Lew worked in tandem
on last year's agreement with Republicans to extend government funding
for the rest of FY 2011, a negotiation that threatened to shut the
government down last April.
On January 10, the White House announced that Cecilia
Muñoz, currently serving as director of intergovernmental affairs, has
been named as director of the Domestic Policy Council. Muñoz will
coordinate the policymaking process and supervise the execution of
domestic policy in the White House. The White House noted that in her
current work, Muñoz has dealt with health care, local issues, and the
status of Puerto Rico. Prior to joining the Obama Administration, she
served as senior vice president at the National Council of La Raza, the
nation's largest Latino civil rights organization. She covered a
variety of issues there including employment, poverty, farmworkers'
issues, education, health, housing, and immigration. More details are
posted at http://www.whitehouse.gov/the-press-office/2012/01/10/president-obama-announces-new-white-house-director-domestic-policy-counc.
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Health
Services
CMS
Releases Adult Quality Measures
On January 4,
the Centers for Medicare and Medicaid Services (CMS) Center for
Medicaid, CHIP, Survey and Certification announced the initial core set
of health quality measures for Medicaid-eligible adults in a final rule
published in the Federal
Register. Required by Section 2701 of the Affordable Care
Act, which amends Section 1139B of the Social Security Act, the quality
measures are composed of existing measures captured by state Medicaid
agencies' reporting systems and other private and/or public health care
coverage. Prior to approval by the secretary of the Department of
Health and Human Services, the voluntary measures were initially
determined and then recommended by the Agency for Healthcare Research
and Quality's (AHRQ) Subcommittee of the National Advisory Council for
Healthcare Research and Quality. The subcommittee published its initial
recommendations in the December 31, 2010, Federal Register and
requested public comments by March 2011.
The subcommittee
initially released 51 measures in 2010 that spanned four different
dimensions: Adult Health; Maternal/Reproductive Health; Complex Health
Care Needs; and Mental Health and Substance Use. After receiving public
comments, which included an additional 43 proposed measures, CMS and
AHRQ identified five criteria for the subcommittee to evaluate the
initial and publicly recommended measures. The criteria included
importance; scientific evidence supporting the measure; scientific
soundness of the measure; current use in and alignment with existing
federal programs; and feasibility for state reporting. Based on
these criteria, the subcommittee reduced the amount of adult quality
measures to 26. Some of the final measures include Adult BMI Assessment;
Breast Cancer Screening; Follow-Up after Hospitalization for Mental
Illness; Annual HIV/AIDS Medical Visit; Comprehensive Diabetes Care
(LDL-C Screening); and Care Transition/Transition Record Transmitted to
Health Care Professional. To access the final rule and the complete
listing of the adult health quality measures, visit http://www.federalregister.gov/articles/2012/01/04/2011-33756/medicaid-program-initial-core-set-of-health-care-quality-measures-for-medicaid-eligible-adults#p-23.
Report
Examines State Policies and Practices on "Aging in Place"
The AARP Public Policy Institute (PPI) and the National
Conference of State Legislatures (NCSL) have released a report, Aging in Place: A State
Survey of Livability Policies and Practices. The report
builds on earlier work by PPI and NCSL to offer state legislators and
officials concrete examples of state laws, policies, and programs that
foster aging in place. This latest research report is intended to help
state legislators, legislative staff, and other interested parties to
explore how land use, transportation, and housing policies can promote
access to services for older adults to better facilitate aging in place
as well as positive health, social, and environmental outcomes. Within
the areas of land use, transportation, and housing, the report examines
a variety of policy approaches to livability such as transit-oriented
development, human service transportation coordination, and models that
provide home- and community-based services (for example, Naturally
Occurring Retirement Communities). The report analyzes current federal
and state statutory law, relevant agency regulations, state programs,
and recent state legislative activity. It includes numerous state
examples that illustrate policies and practices from around the
country. To access the report, visit http://assets.aarp.org/rgcenter/ppi/liv-com/aging-in-place-2011-full.pdf.
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Economic/Work Support
Wyden
Introduces Bill on Use of SNAP for Nutritious Foods
On December 16,
Sen. Ron Wyden (D-OR) introduced the Fresh Regional Eating for Schools
and Health Act of 2011, S. 2016. Under the bill, the U.S. Department of
Agriculture (USDA) could conduct projects that would restrict purchases
under the Supplemental Nutrition Assistance Program (SNAP) to foods
that could be expected to help recipients meet federal nutrition
guidelines. States wanting to implement such a project would be
required to first solicit public input. The legislation would also
require retailers with annual SNAP sales in excess of $1 million to
provide USDA with an annual list of the foods purchased with SNAP
benefits. USDA would then compile and submit the data to Congress. The
bill would also require that states offer alternative forms of Special
Supplemental Nutrition Assistance Program for Women, Infants and
Children (WIC) training to retail stores so they could provide
supplemental foods under the program. The bill's text is available at http://thomas.loc.gov.
Administration
Launches Summer Youth Employment Initiative
On January 5, the
White House announced a new initiative to promote summer employment and
work experience for youth. The initiative, Summer Jobs+, calls for
businesses, nonprofits, and government to work together to provide
avenues to employment for low-income and disconnected youth in the
summer of 2012. The initiative commits the federal government and the
private sector to creating 180,000 summer employment opportunities for
youth. Employers are invited to participate by providing a range of
work opportunities such as internships, on-the-job training, mentoring
programs, workshops, and job shadow days. A number of government,
nonprofit, and private employers have announced commitments to provide
summer jobs for youth, including employers such as Easter Seals and
Bender Consulting Services that have committed to providing
opportunities for youth with disabilities. Additionally, the
Administration announced its intention to launch, within 60 days, the
Summer Jobs+ Bank, a one-stop search tool for youth to access postings for
participating employers. For more information, visit http://www.dol.gov/summerjobs/.
DOL
Releases TEN on Employment-Related Transportation Needs and Services
On January 3,
the Department of Labor's Employment and Training Administration and
Office of Disability Employment Policy issued a Training and Employment
Notice (TEN) on strategies to meet job-seeker and employer needs for
employment-related transportation services. The TEN notes that
transportation can sometimes be overlooked as a critical service for
job seekers, employees, or individuals needing training, particularly
for individuals with specialized mobility needs such as people with
disabilities, older workers, disabled veterans, youth, or low-income
earners who may depend on public transit. The TEN identifies strategies
that state and local workforce investment boards could use to resolve
employment-related transportation issues. These strategies include, for
example, sharing labor market information with the transportation
community, convening workforce and transit agencies, and supporting
regional transportation initiatives. The TEN also identifies strategies
that management and staff of one-stop career centers can use to improve
access to transportation options. For example, management could
designate a part or full-time staff person as a transportation
"navigator" for the regional one-stop career center system.
Career center counselors can ask key transportation questions during
intake and assessment, and develop general knowledge of transportation
options and supports. Business service representatives can likewise
engage employers on their transportation needs and potential solutions.
Finally, the TEN lists general and specialized transportation
resources. The TEN is available at http://wdr.doleta.gov/directives/attach/TEN/ten2011/ten21-11acc.pdf.
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Child Care
House
Introduces Bill to Expand Child Care Resources for Military Families
Prior to
Congress' adjournment last December, Rep. John Carter (R-TX) introduced
the Military Families Child Care Assistance Act of 2011, H.R. 3540. The
bill would amend the Internal Revenue Code of 1986 to increase tax
benefits so military families can have greater access to child
care. The bill's purpose is to recognize the importance of
parental choice by enabling military families to afford child care that
suits their individual needs. According to the bill's provisions,
individuals who have served on active duty in the Armed Forces for a
period of 120 days or more (starting from September 11, 2001) can
receive a dependent care tax credit for household and dependent care
expenses, including those related to child care. The text of H.R. 3540
is available at www.thomas.gov.
House
Committee Releases Two Draft Bills to Reauthorize ESEA
On January 6,
House Education and Workforce Committee Chairman John Kline (R-MN)
released two draft bills reauthorizing the Elementary and Secondary
Education Act (ESEA). The draft bills make significant revisions to the
No Child Left Behind Act (P.L. 107-110), and are designed to improve
state and local education agencies' performance by reauthorizing the
accountability and teacher quality provisions of ESEA. One draft bill,
the Student Success Act, addresses the K-12 accountability,
assessments, and standards components of ESEA. The bill's provisions
would reform the current adequate yearly progress measure, which
currently requires all schools to meet certain targets for student
proficiency or face federal sanctions. It would also provide states
with greater flexibility in implementing school improvement strategies.
The second draft
measure, the Encouraging Innovation and Effective Teachers Act, would
reauthorize teacher quality programs by providing federal grants to
support teacher evaluation systems and consolidating them into a new
"Teacher and School Leader Flexible Grant" program. The
legislation would also encourage parent engagement activities and
promote state and local-led innovation in schools.
In the summer of
2011, the House Education and Workforce Committee held hearings and
passed three bills to reauthorize ESEA, restructure charter school
programs, increase state flexibility, and improve accountability. The
Senate Health, Education, Labor and Pensions Committee approved an ESEA
reauthorization bill in the fall, which highlights the similar
principles for education reform as the House bills; however, its
provisions are vastly different. The Student Success Act is available
at http://edworkforce.house.gov/UploadedFiles/The_Student_Success_Act.pdf,
and the Encouraging Innovation and Effective Teachers Act is at http://edworkforce.house.gov/UploadedFiles/The_Encouraging_Innovation_and_Effective_Teachers_Act.pdf.
ACF
Requests Comments on Reporting Improper Payments Regarding CCDF Funds
On January 10,
the Administration for Children and Families (ACF) released a notice in
the Federal
Register (77
FR 1494) requesting comments on the Child Care and
Development Fund's (CCDF) improper payment reports. The purpose of the
request is to announce ACF's proposal to collect information on states'
compliance with the Improper Payments Information Act of 2002 (IPIA)
and the Improper Payments Elimination and Recovery Act of 2010. Section
2 of the IPIA of 2002 requires states to prepare and submit a report of
errors connected with the administration of CCDF grant funds once every
three years. The Office of Child Care (OCC) is completing the second
three-year cycle of case record reviews. OCC has evaluated the case
record review process to determine if "improper authorizations for
payment" accurately capture actual "improper payments"
as a result of these federal audits. In some cases, the OCC found that
the authorizations for payment reflected the same figure as actual
payments; in other cases, authorizations for payment represented a
figure as much as "20 percent higher than actual payments."
Some states have reported regulatory barriers in state law that hinder
the recovery of overauthorization or overpayment as the result of
agency error.
APHSA's
affiliate the National Association of State Child Care Administrators
has recommended that ACF shift the focus of the CCDF error rate
methodology to actual payments, and the OCC's action has taken APHSA's
recommendation into consideration. In addition, the OCC agrees that
this revision will create a streamlined process for allowing greater
efficiency in conducting reviews and reducing administrative burdens on
lead CCDF agencies.
Comments must be submitted in writing to the ACF Office of
Planning, Research and Evaluation, 370 L'Enfant Promenade, S.W.,
Washington, DC 20447, Attn: ACF Reports Clearance Officer, or at infocollection@acf.hhs.gov.
The deadline to submit comments is March 9, 2012. The Federal Register
notice can be found on the OCC web site at http://www.acf.hhs.gov/programs/occ/.
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Program
Accountability
Collaborative
Forum Work Groups Meet
Two
Collaborative Forum Work Groups met this week to develop ideas into
concept papers for possible funding through the Partnership Fund for
Program Integrity Innovation. The Office of Management and Budget
estimates that it would take two to three months to vet and move each
concept paper forward for approved funding. The Partnership Fund still
has funding to be distributed by September 2012. On January 10, the
Scorecard Work Group met to review methods and tools that state and
local agencies could use for measuring and evaluating whether, and to
what extent, contracted service providers are achieving desired program
outcomes and at what cost. The pilot options under consideration
are:
- Fund a
study analyzing existing data from selected states and localities
and their service providers to identify relationships between
criteria for provider evaluation and outcomes and the
cost-effectiveness of results achieved by providers with the best
outcomes. The results would be used to create a model scorecard
that shows useful criteria.
- Create
and test a "dashboard" for state/local human service
agencies and service providers to share and track performance and
outcomes to provide real-time assessments of progress made toward
achieving outcomes, as opposed to annual reviews.
On January 12,
the Identity Verification Work Group met to develop a pilot to test
appropriate standards for establishing the identity of an applicant for
federal, state, or local government benefits and/or services, with
emphasis on security and interoperability. The group's focus is an
enterprise approach that engages the appropriate support from higher
governmental levels, such as the governor's office, and reaches out to
the agency and consumer to determine the level of risk that each finds
acceptable. The group will hold bi-monthly meetings and review
materials through e-mail, and may conduct some interviews with
stakeholders as well. A template will be distributed that group members
will populate with ideas and knowledge of initiatives already under
way. The numerous initiatives must be aligned to avoid redundancies and
duplication of effort. The goal is to have a viable paper to submit in
45 days.
Those interested
can join this and other work groups, submit comments, and access
concept papers and other documents by visiting the Collaborative Forum
web site at http://collaborativeforumonline.com/.
Upcoming Events:
January 20, 11:00-12:00 p.m. EST
National Eligibility Database Work
Group
January 24, 1:00 p.m. EST
Collaborative Forum Monthly Meeting
January 26, 3:00 p.m. EST
Identity Verification Work
Group
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People on the Move
Herger
Among Recent Congressional Retirement Announcements
Wally Herger
(R-CA), who has been in Congress for 13 terms, announced this week that
he is retiring from Congress. Herger has served on the House Ways and
Means Committee and is chairman of the panel's Health Subcommittee. He
joins a number of other members who have announced their retirements,
including two other California Republican representatives, Elton
Gallegly and Jerry Lewis; Lewis served as chairman of the
Appropriations Committee from 2005 to 2006. All three members have been
dealt a difficult hand by the state's bipartisan redistricting
commission and would face uncertain reelection prospects. There are now
29 House members who are either retiring or running for a different
office, and nine Senators have announced their intention to retire as
well.
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This
Week in Washington is published by the American Public Human
Services Association each week Congress is in session
and on other dates.Editor:
Larry Goolsby. Writers:
Phil Basso (practice innovation), Cynthia Blankenship
(health), Rashida Brown (child care, child welfare), Christina
Crayton (child welfare), Robert Ek (TANF, child support), Summer
Gill (Policy and Programs Department intern), Megan Lape
(health), Bertha Levin (child welfare, program integrity), Anita Light
(children and family services), Nanette Relave (health), Ron Smith
(legislative affairs) and Gary Terpstra (SNAP).
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