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December
16, 2011 | Vol.
XXXII | No.
43
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 Top
Stories
Week of Congressional Brinkmanship
Ends with Mixed Results
After a week of
uncertainty, House and Senate appropriators appear to have agreed to a
$1 trillion-plus, year-end omnibus appropriations bill for fiscal year
2012. The action comes just in time to avert a government shutdown that
was otherwise set to occur when the current continuing resolution (CR)
funding bill expired at midnight on December 16. However, while the
immediate funding issues seem resolved, there are other
"must-pass" bills that are still in limbo. The House passed a
payroll tax extension bill earlier this week that contains numerous
measures, including unemployment benefits and the Medicare "doc
fix," as well as provisions dealing with the Keystone pipeline
(that President Obama strongly opposed). As of press time, it was not
clear what concessions either side has made on this bill or how long
Congress might have to remain in session to resolve the differences.
The political rhetoric used by both sides to describe the opposition's
position on this bill eased somewhat as the week progressed, indicating
some movement in negotiations, but at press time a final agreement
still seemed elusive.
Both House
Speaker John Boehner (R-OH) and Senate Majority Leader Harry Reid
(D-NV) have been maneuvering all week on how to gain the best political
advantage with the omnibus appropriations bill and the payroll tax
measure. There has been talk of simply extending the payroll tax
holiday by two months to give Congress time to resolve its differences.
Both Republicans and Democrats want to extend the payroll tax holiday
but so far cannot agree on how to pay for it. Boehner said on the
morning of December 16 that the House will return next week and plans
to pass the two-month payroll tax holiday extension and that it will
insist on including the Keystone pipeline language.
The omnibus
appropriations bill is more than 1,200 pages long, meaning it will take
time for organizations outside Congress to fully comprehend all its
provisions. It reportedly includes a compromise version of the Labor,
Health and Human Services (HHS), and Education appropriations bill.
President Obama is expected to sign the bill if the Congress can pass
it.
APHSA
Releases Pathways Policy Vision, Challenges Presidential Candidates
On December 16,
APHSA launched its Pathways: The Opportunities Ahead for Human Services
policy initiative by issuing an open letter to the 2012 presidential
candidates. The open letter challenges them to develop
comprehensive platforms that address the national human service
structure and offers help as they create their plans.
As a guide for
the candidates, the letter outlines APHSA's Pathways, an outcomes-based,
integrated, client-centric policy agenda-the first ever for APHSA with
this specific and consistent focus. While APHSA has put forth robust
policy agendas in the past, they have concentrated more on specific
programmatic needs instead of the outcomes they hope to help achieve by
implementing those policies.
Pathways
was developed in coordination with APHSA's governing policy council,
made up of cabinet-level commissioners of health and human service
agencies, the association's nine affiliates through their leadership
committees, and a working group designated by the policy council.
At the centerpiece of Pathways
are four major outcomes that APHSA seeks:
- Achieving
gainful employment and independence
- Stronger
families, adults, and communities
- Healthier
families, adults, and communities
- Sustained
well-being of children and youth
The results of
this work will be released in two phases - the first phase, which
begins with the open letter, lays out APHSA's vision and an overarching
action framework for national policymakers. The second will contain a
more detailed set of policy recommendations and will be forthcoming in
2012. Information on Pathways,
as well as a copy of the open letter, can be found at www.aphsa.org/Policy/pathways.asp.
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Child Welfare
Sutton
Testifies for APHSA and NAPCWA at Hearing on Child Abuse Reporting Laws
On December 13,
Erin Sullivan Sutton, assistant commissioner of children and family
services for the Minnesota Department of Human Services and past
president of APHSA's affiliate, the National Association of Public
Child Welfare Administrators' (NAPCWA), testified before the Senate
Health, Education, Labor and Pensions Subcommittee on Children and
Families. The occasion was a hearing titled, "Breaking the Silence
on Child Abuse: Protection, Prevention, Intervention and
Deterrence." The panel held the hearing in response to recent
allegations of child sexual abuse at Pennsylvania State University and
adults' failure to report the alleged crimes. Subcommittee Chairman
Barbara Mikulski (D-MD) was joined by Ranking Member Richard Burr
(R-NC) and Sen. Robert Casey (D-PA) in organizing the hearing so that
Congress could examine child abuse and neglect laws and find ways to
strengthen requirements for mandated child abuse reporters. On November
16, Senator Casey introduced the Speak Up to Protect Every Abused Kid
Act (S. 1877), which would amend the Child Abuse Prevention and
Treatment Act (CAPTA) to require that all adults report suspected abuse
and neglect. Currently, 18 states have expanded their definition beyond
the traditional professionals classified as mandated reporters to
require that "all adults" report suspected abuse and neglect.
Sutton
recommended that Congress pass legislation on comprehensive child
welfare finance reform to blend federal child welfare funding streams
and provide states with greater flexibility to use those dollars
effectively to prevent children from entering into formal foster care
and to ensure their safety. She explained the challenges child welfare
agencies face when determining better ways to provide services to
vulnerable children and families in tough economic times. Sutton reminded
Congress that the Budget Control Act did not exempt CAPTA from
sequestration and that sequestration will limit child welfare agencies'
capacity to adequately serve children and families. Other witnesses
included Sheldon Kennedy, former National Hockey League player and
co-founder of Respect Group Inc. (Canada); Michelle Collins, assistant
to the president for the National Center for Missing and Exploited
Children; Frank Cervone, executive director of Support Center for Child
Advocates; Robert Block, president of the American Academy of
Pediatrics; and Teresa Huizar, executive director of the National
Children's Alliance. The witnesses' statements are posted at http://help.senate.gov/hearings/hearing/?id=12f57f31-5056-9502-5d46-d6c877eaa515.
Bill
Introduced to Create Child Deaths Commission On
December 13, Senators John Kerry (D-MA) and Susan Collins (R-ME) and
Representatives Lloyd Doggett (D-TX) and Joseph Crowley (D-NY)
introduced legislation (S. 1984 and H.R. 3653) to create a commission
charged with reducing child fatalities. The bill provides that the
President appoint a commission composed of 12 to 15 stakeholders with
expertise in related fields including social work, health, law, and
education. The commission would study the incidence of child
fatalities, record keeping, best practices, and resource limitations.
The commission would then develop a strategy engaging federal, state,
and local agencies and private organizations to respond to maltreatment
and reduce child fatalities. The commission's recommendations would be
due within in three years and the legislation would authorize $2
million to meet associated expenses. The full text of the House and
Senate bills can be found at http://thomas.loc.gov/home/thomas.php.
GAO Releases
Report on Oversight of Psychotropic Prescriptions in Foster Children
On December 14,
the Government Accountability Office (GAO) released its final report, Foster Children: HHS
Guidance Could Help States Improve Oversight of Psychotropic
Prescriptions (GAO-12-201), on overutilizing prescribed
psychotropic medication forfoster care children in Medicaid. The
subject was covered at a December 1 congressional hearing during which
GAO's director of forensic audits and investigative services, Greg
Kuntz, provided oral and written testimony to the Senate Homeland
Security and Governmental Affairs Subcommittee on Federal Financial
Management, Government Information, Federal Services, and International
Security (see This
Week, December 9). The final version of the GAO report
includes comments provided by HHS and the states studied for the report
(Florida, Massachusetts, Maryland, Michigan, Oregon, and Texas).
This concern is
not new for state child welfare agencies or state Medicaid agencies.
Texas, for example, began implementing cross-system initiatives toward
reducing the rates of psychotropic medication utilization in foster
children since 2004. Several factors are involved in why these rates
are higher for foster children in Medicaid than non-foster children in
Medicaid, and as the report acknowledges, it is difficult to identify
any one cause. GAO studied only foster and non-foster children data in
fee-for-service plans and not managed care plans. The report noted that
state practices (e.g., prescription drug coverage) vary and that foster
children have higher chances of being exposed to trauma. Other factors
cited include multiple changes in foster care placements, disruptions
in care, and concomitant psychotropic drug prescriptions.
Last June,
Congress passed the Child and Family Services Improvement and
Innovation Act of 2011 (P.L. 112-35), which reauthorized Title IV-B of
the Social Security Act. The title includes the Promoting Safe and
Stable Families Act. It also includes a new requirement for states to
change their Child and Family Services Reviews to include protocols for
monitoring psychotropic medication utilization in foster children and
to require states to utilize trauma-informed care for children removed
from their home. GAO recommends that HHS endorse guidance to state
Medicaid and child welfare agencies on best practices for monitoring
psychotropic drug prescriptions for foster children addressing at
minimum, interventions for informed consent, oversight, consultation, and
information sharing. The report compares the six states' laws and
policies related to the American Academy of Child and Adolescent
Psychiatry's (AACAP) monitoring guidelines. Out of AACAP's 20 best
principles guidelines, the smallest number utilized (either partially
or fully) by any one state was six (Michigan), and the highest was 17
(Texas).
HHS acknowledges
that in light of increased understanding of the impacts of maltreatment
and the growing knowledge of evidence-based interventions for children in
foster care who have been abused or neglected, the child welfare system
has not been able to consistently implement them. Two of the reasons
that HHS provided are the lack of availability of the interventions for
the system and the lack of capacity by the system to fully incorporate
them into practice. In a state director letter issued on November 23 by
the Administration for Children and Families (ACF), the Centers for
Medicare and Medicaid Services, and the Substance Abuse and Mental
Health Services Administration these three agencies provided states
with guidance on complying with new requirements and other ways they
might capture data for the collaborative efforts toward enhancing
oversight on prescribing psychotropic medications to foster care children
of all ages. The letter is available at http://hsd.aphsa.org/home/doc/State-DirectorLetter-Joint-ACF-CMS-and-SAMHSA.pdf,
and the GAO report is available at www.gao.gov/assets/590/586906.pdf.
ACF
Releases 2010 Child Maltreatment Report
ACF has released
its annual report on child abuse and neglect, Child Maltreatment 2010,
the 21st report in the series, which shows a steady decline, for the
fourth consecutive year, in the number of victims who suffered
maltreatment. An estimated 754,000 children were determined to be
victims of maltreatment in 2010, down from 763,000 victims in 2009. As
in past years, rates of abuse and neglect are highest among infants and
young children. In the report, ACF states that it is implementing major
initiatives geared toward decreasing the rate of child abuse and
neglect and ensuring that children who have experienced maltreatment
receive the services they need to heal and recover. To prevent
maltreatment and support the needs of infants and young children, ACF
is supporting grantees in ten states to enhance collaboration between
early childhood and child welfare systems. ACF also awarded $10.5
million for fiscal year 2010-2011 in Affordable Care Act funds for the
Tribal Maternal, Infant and Early Childhood Home Visiting program,
which addresses the diverse needs of at-risk American Indian and Alaska
Native children and families and assures effective coordination and
delivery of child abuse and neglect prevention. The full report is
available at www.acf.hhs.gov/programs/cb/pubs/cm10/.
ACF
Releases Program Instructions IV-E Plan Amendments
ACF has released
a program instruction, ACYF-CB-PI-11-07, with changes to the Title IV-E
plan requirements as outlined in the Child and Family Services
Improvement and Innovation Act (P.L. 112-34). The changes to this
legislation, which reauthorized Title IV-B of the Social Security Act,
were effective on October 1. The act included amendments for case
plan and case review system requirements and the Adoption Assistance
Program reinvestment requirements in Title IV-E. Title IV-E
agencies are required to submit the plan amendment to the appropriate
Children's Bureau Regional Program Manager for approval no later than
January 31, 2012. The links to the program instruction can be found at www.acf.hhs.gov/programs/cb/laws_policies/policy/pi/2011/pi1109.pdf.
NYTD
Technical Working Group Accepting Applications
The National
Youth in Transition Database (NYTD) Technical Working Group (TWG)
is a new forum for state staff and young people to discuss and offer
recommendations to federal NYTD staff. This new group will further
federal work with states in developing technical assistance products
and system enhancements that are designed to improve state collection,
reporting, analysis, dissemination, and use of NYTD
data. Prospective members should possess a working knowledge of
NYTD requirements and basic knowledge of the federal NYTD system
and how it is used. Members should also be actively engaged in the
state's efforts to collect, analyze, and use NYTD data or in building
partnerships between the state and young people to achieve these
goals. State staff is welcome to nominate young people engaged in
NYTD implementation for the TWG. Those with questions about TWG
membership, roles, and responsibilities, or who would like to become a
TWG member, should contact Elizabeth Mertinko at emertinko@icfi.com. Applications are due no later
than December 23.
Initiatives
Aim to Help Prevent Teen Pregnancy and Support Foster Youth
The Annie E.
Casey Foundation is supporting two complementary initiatives to help
states and localities continuously improve a continuum of services to
help teens in foster care make informed, proud decisions related to
their sexuality. Leaders from the two initiatives are coordinating to
provide consistent messages and optimal support to participating teams,
and states and localities seeking to strengthen a full continuum of
services to prevent teen pregnancy and support already pregnant and/or
parenting youth in foster care are encouraged to apply to participate
in both initiatives.
NAPCWA, APHSA,
and the National Campaign to Prevent Teen and Unplanned Pregnancy are
jointly presenting an institute to help at least five teams incorporate
evidence-based pregnancy prevention practices customized for foster
youth into day-to-day practice of child welfare agencies. The institute
will cover most costs for in-person sessions and intersession technical
assistance. The institute application will be released on January 3,
2012, and the submission deadline will be January 31. The first
in-person session will be April 26-27, with sessions to follow in June,
October, and December and June of 2013. For more information, contact
Robin O'Brien at (202) 682-0100 x246 or robrien@aphsa.org.
For the second
initiative, the Center for the Study of Social Policy (CSSP) is seeking
proposals by January 17, 2012,from public state and local child welfare
agencies and tribes committed to expanding their service array and
policy framework to improve outcomes for pregnant and parenting youth
in the foster care system. CSSP expects to create a Pregnant and Parenting
Youth National Peer Learning Networkwith three jurisdictions or tribes
which will enable those sites to benefit from the experiences and
lessons learned from their colleagues across the country and ultimately
inform a national agenda for serving this population. All costs for
participation in the Learning Network will be covered. There is an
information webinar on December 19 from 1:30 to 3:00 p.m. Eastern time.
For more information, contact Elizabeth Black at elizabeth.black@cssp.org or (202) 371-1565 or see www.cssp.org/publications/child-welfare/child-welfare-misc/Pregnant-and-Parenting-Youth-Letter-of-Interest-Invitation.pdf
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Economic/Work Support
House
Passes TANF Extension; Senate Action Still Cloudy
On December 15,
the House passed an extension of the Temporary Assistance for Needy
Families (TANF) block grant, the Welfare Integrity and Data Improvement
Act (H.R. 3659), that would be effective through September 30, 2012.
The bill requires states to have policies and procedures in place to
block electronic benefit transfer (EBT) transactions at certain
facilities, such as liquor stores, casinos, and strip clubs. It also
includes language that would require the Office of Management and
Budget to explore standardization of nonproprietary data elements.
While the bill does extend funding for the TANF block grant, it does
not provide any new funding for the already depleted TANF Supplemental
Grants received by 17 states.
The legislation
was introduced on the evening of December 14 and brought to a vote
under a suspension of the rules the next afternoon, passing by a vote
of 330 to 83. The language was originally part of a larger legislative
package to extend a number of tax breaks scheduled to expire at the end
of the calendar year; however, that bill passed by a narrow
vote in the House and received not only a chilly reception in the
Senate but also a veto threat from the White House.
With the clock
ticking on many programs set to expire December 31, including TANF,
Congress is feeling some urgency to move extensions of programs that
are not controversial so that the body can focus on more contentious
issues. The TANF extension now moves to the Senate, where its fate is
still uncertain. It is not clear whether the Senate will vote on the
language that it received from the House verbatim or if it will send
back the language to the House with modifications.
Rule
Would Strengthen Affirmative Action Requirements for Individuals with
Disabilities
In the December
9 Federal
Register, the Department of Labor's Office of Federal
Contract Compliance Programs issued a Notice of Proposed Rulemaking
that would revise the regulations implementing the nondiscrimination
and affirmative action regulations of Section 503 of the Rehabilitation
Act of 1973, as amended. Section 503 prohibits discrimination by
covered federal contractors and subcontractors against individuals on
the basis of disability and requires affirmative action on behalf of
qualified individuals with disabilities. In light of the substantial
disparity in the employment rate of individuals with disabilities, the
proposed regulations would strengthen the affirmative action provisions
by describing specific actions a contractor would need to take to
satisfy its obligations. The rule would also revise the
non-discrimination provisions to implement changes necessitated by the
passage of the Americans with Disabilities Act Amendments Act of 2008.
This proposed rule follows on an Advance Notice of Proposed Rulemaking
issued on July 23, 2010, that requested public comment on specific
questions regarding potential ways to strengthen the Section 503
affirmative action regulations.
The proposed
regulatory changes detail specific actions that contractors would need
to take in recruitment, record-keeping, and other areas, similar to
actions that have been required to promote workplace opportunities for
women and minorities. The proposed changes include, for example:
- Hiring
goals: the proposed rule would establish, for the first time, a
national goal for individuals with disabilities. Federal
contractors and subcontractors would be required to set a hiring
goal of having 7 percent of their employees to be workers with
disabilities in each job group of the contractors' workforce.
- Record
keeping: the proposed rule would require that contractors maintain
records on the number of individuals with disabilities applying
for positions and the number of individuals with disabilities
hired.
- Accommodation
requests: the proposed rule would require that contractors develop
and implement written procedures for processing requests for
reasonable accommodation.
- Outreach:
the proposed rule would require that contractors engage in a
minimum of three specific types of outreach and recruitment
efforts to recruit individuals with disabilities.
- Job
listings: the proposed rule would require that contractors list
job openings with One-Stop Career Centers or other appropriate
employment delivery systems.
Comments on the
proposed rule are due on or before February 7, 2012. The proposed rule
is posted at www.gpo.gov/fdsys/pkg/FR-2011-12-09/html/2011-31371.htm.
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C h i l
d C a r e
Nine
States Win Race to the Top Awards
On December 16,
Department of Education Secretary Arne Duncan and HHS Secretary
Kathleen Sebelius announced the winners of the $500 million Race to the
Top Early Learning Challenge (RTT ELC) grant program. Out of 37
applicants, nine states will receive grant funding for four years to
close their school readiness gap and improve high-quality care and
education for low income children. The states include California,
Delaware, Maryland, Massachusetts, Minnesota, North Carolina, Ohio,
Rhode Island, and Washington. The winning states will receive the grant
funds at the end of the month. More details are available at wwww.hhs.gov/news/press/2011pres/12/20111216a.htmlww.hhs.gov/news/press/2011pres/12/20111216a.html.
Inspector
General Reports Negative Audit Results on 24 Head Start Grantees
On December 13,
the HHS Office of Inspector General (OIG) released a report reviewing
24 Head Start grantees' compliance with health and safety requirements.
The Office of Audit Services and the ACF Office of Head Start worked in
collaboration to select the grantees being reviewed for the audits,
which were conducted from May 2009 through October 2010. The report
indicated that none of the grantees reviewed were fully compliant with
the federal Head Start program or their state and local requirements to
protect children from unsafe materials and equipment. Regulations under
the Head Start Act at 45 CFR 1304.53(a)(10) require grantees to
"conduct a safety inspection at least annually to ensure that each
facility's space, light, ventilation, heat and other physical
arrangements are consistent with the health, safety and developmental
needs of children." Most of the grantees were not compliant with
conducting criminal background checks and checks on child abuse and
neglect registries. Among the grantees' employees, 24 percent were not
compliant with all federal and state pre-employment requirements. The
audit found that 54 percent of the facilities did not have playground
equipment in good repair, and 63 percent had play areas where
conditions were potentially harmful to children.
The report
recommends that ACF should (1) ensure that Head Start grantees comply
with health and safety regulations through onsite monitoring; (2)
perform an analysis to determine whether it should seek legislative
action to amend federal health and safety requirements that would
require periodic background checks of all Head Start employees; and (3)
amend current regulations to require any prospective and current
employees of Head Start facilities be disqualified or terminated from
employment if a conviction has been indicated on their criminal record.
The OIG report is posted at http://oig.hhs.gov/oas/reports/region10/11102503.asp.
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B u d
g e t/F i n a n c e
Fiscal
Survey of States Shows Budgets Still Tight
On November 29,
the National Governors Association and the National Association of
State Budget Officers released the Fall
2011 Fiscal Survey of States. The report shows that while
the overall fiscal condition of states has improved from the depths of
the recession, states are facing a "big squeeze" from both
local and federal governments. The combination of the effects of the
economic downturn, tepid economic growth, and the expiration of
American Recovery and Reinvestment Act and other federal funds has severely
impeded the growth of state resources. Overall, state budgets enacted
for 2012 include nearly $667 billion in general fund expenditures, a
2.9 percent increase compared with $648 billion in general fund
spending in 2011. Despite the second year with an increase, total
enacted general fund spending in 2012 is still $21 billion less than
the pre-recession high of $687 billion in 2008. The full report is
available at www.nga.org/cms/home/news-room/news-releases/page_2011/col2-content/main-content-list/nga-nasbo-say-states-facing-big.html.
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P r o g r a m I n
te g r a t i o n
HHS Secretary Named New Chair of
Interagency Council on Homelessness
The U.S.
Interagency Council on Homelessness (USICH) has elected HHS Secretary
Kathleen Sebelius as its new council chair. USICH, an independent
agency within the federal executive branch composed of 19 cabinet
secretaries and agency heads, brings together expert knowledge from
federal and state programs in the child welfare, education, housing,
and juvenile justice sectors to prevent and end
homelessness. Additional information and on the council can be
found at www.usich.gov.
Secretary Sebelius released a statement following her election, which
is available at www.hhs.gov/news/press/2011pres/12/20111214a.html.
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Program
Accountability
Collaborative
Forum Moves Several Projects Forward
Several
committees and work groups under the Collaborative Forum held meetings
this week to examine and recommend feasible ideas for possible support
through the Partnership Fund for Program Integrity Innovation in 2012.
On December 12, the Scorecard Work Group recommended that the Scorecard
concept move forward, with three jurisdictions expressing interest in
sponsoring the project. The District of Columbia and Massachusetts
would pursue applications in juvenile justice, and North Carolina
proposed a broader scope that would incorporate child care and mental health.
Next steps will include looking at viable benchmarks and measurable
outcomes in these areas.
The Ideas
Committee met on December 13 and recommended moving ahead with the
Verifying Eligibility in a Virtual World concept. The group decided to
form a work group for project development, and recommends that
implementation start small with a few programs in a few jurisdictions
and that solutions should be flexible for expansion. The work group
will first identify all necessary stakeholders and quantify the size of
the problem. The group anticipates that as it explores the universe of
challenges and solutions to verifying identity, the scope of the
objective will evolve. One early priority is to establish standards for
authenticating a person's claim of identity.
The National
Eligibility Database Work Group met on December 15. Michigan shared its
experience in setting up and managing its enterprise data warehouse for
all state agencies; this is a rate-based, cost-effective service as no
one agency will have to bear the cost of building or maintaining the
system. Agencies joined the data warehouse voluntarily as they realized
the benefits of the enterprise. Each agency has access to both its data
and the data of other agencies as authorized by interagency agreements.
There are sophisticated security measures in place; each user has a
unique profile that limits access to information granted by the
respective agreements. The state uses the data for both customer
information sharing and other purposes; the state's treasury
department, for example, has been able to run predictive analysis on
revenue that can be expected from changes in the tax code.
Upcoming
Events
January
4, 2012, 3:00-4:30
p.m. Eastern
First Meeting of
Verifying Identity in a Virtual World Work Group
January
5, 4:00-5:00 p.m. Eastern
National
Eligibility Database Work Group Meeting
January
11, 3:00-4:30 p.m. Eastern
Ideas Committee
Bi-monthly Meeting
More information
about all projects and events is available at the Collaborative Forum
web site, http://collaborativeforumonline.com.
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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), 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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