Washington update.

House and Senate Continue Work on Health Care Reform

Both the House and Senate continue to develop their respective versions of a comprehensive health care bill. Despite earlier intentions to finish work before the August break, it seems clear now that hammering out details of a legislative package will continue well into the fall.

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At press time, the Senate Health, Education, Labor and Pensions Committee had worked through portions of a draft measure. The Congressional Budget Office scored the plan as reducing the uninsured population by just 16 million at a 10-year cost of $1 trillion, leading to criticism for the plan's high costs. Sen. Christopher Dodd (D-Conn.) said incomplete scoring of long-term care provisions was one reason he delayed completion of the committee's work into at least July. Tasks ahead for the committee include finalizing language on creating a public plan and "pay or play" mandates that would penalize employers that did not offer coverage. Dodd hopes the panel will soon have numbers on how to cover the uninsured and pay for the proposals. Republicans have offered approximately 200 amendments to the proposed legislation.

Meanwhile, Senate Finance Committee Chair Max Baucus (D-Mont.) said he has developed language for his committee's version of health care reform that would reduce the price tag to about $1 trillion over 10 years and thus gain bipartisan support. Although the committee did not release details of the plan, it did propose capping the tax exclusion for employer-sponsored benefits; giving more power to the Medicare Payment Advisory Commission while allowing Congress to overturn the recommendations; and replacing the controversial public plan option with a consumer-owned "co-op" plan.

In the House, the Energy and Commerce and Education and Labor committees have held public hearings on the House leadership's health care measure. The hearings have focused so far on the merits of creating a government-run insurance plan to compete with private insurers and on how to finance an overhaul. Republicans are opposed to the costs of the legislation as well as to what they say is a lack of specificity surrounding those costs. Democrats say they are focused on expanding insurance coverage and making health care more affordable.

Congress Looks at Legislation On Home Visiting; NAPCWA Submits Statement

On June 16, Sens. Robert Menendez (D-N.J.) and Bob Casey (D-Pa.) introduced the Evidence-Based Home Visitation Act of 2009, S. 1267. Unlike its House counterpart, the Senate bill would establish home visiting programs under Title V, the Maternal and Child Health Services Block Grant, administered by the Health Resources and Services Administration. The voluntary programs would be administered by local agencies, including tribes, and would serve low-income pregnant women and families with young children. Funds or services from these programs could not be considered taxable income or used in determining eligibility for other benefits. Models would be approved for funding by the HHS secretary and the director for the Centers for Disease Control and Prevention. Approval would require demonstrated outcomes in reducing abuse and neglect and juvenile delinquency, and improving prenatal and child health and development, school readiness, and family economic self-sufficiency. The bill provides for both planning and operating grants; the legislation authorizes $100 million for fiscal year 2010, with amounts increasing annually and reaching $700 million by FY 2014.

S. 1267 has some language similar to its counterpart House bill, the Early Support for Families Act (H.R. 2667), but also has a number of differences. The House Ways and Means Committee requested that the National Association of Public Child Welfare Administrators, an APHSA affiliate, provide a statement for the record regarding the home visitation legislation. NAPCWA's written testimony comments on the legislation and thanks Congress for its efforts in strengthening home visitation programs. NAPCWA also encouraged Congress to collaborate with public child welfare administrators on this initiative. The statement is available at www.waysandmeans.house.gov.

Recent Administration Appointees Include Former Human Service Administrators

Following are some of those recently appointed or nominated for positions in the Obama administration. Several have worked as state and local human service administrators, as indicated in parentheses.

Carmen Nazario, assistant secretary for Children and Families (secretary for Health and Social Services in Delaware, director of Children and Families in Puerto Rico and local agency director in Virginia)

David Hansell, deputy assistant secretary at the Administration for Children and Families (commissioner, New York State Office of Temporary and Disability Assistance)

Bryan H. Samuels, secretary for the Administration on Children, Youth and Families (director, Illinois Department of Children and Family Services). The Administration on Children, Youth and Families is part of the Administration for Children and Families.

Joan Lombardi, deputy assistant secretary and inter-departmental liaison for Early Childhood Development

Shannon Rudisill, associate commissioner for the Child Care Bureau

Cindy Mann, director of the Center for Medicaid and State Operations

Vicki Turetsky, commissioner of the Office of Child Support Enforcement (division director for the Minnesota Department of Human Services)

Kevin Concannon, undersecretary for Food, Nutrition and Consumer Services (director, Oregon Department of Health and Human Services; commissioner, Maine Department of Human Services; director, Iowa Department of Human Services)

Julie Paradis, administrator, Food and Nutrition Service

Lisa Pino, deputy administrator, Food and Nutrition Service

For more details on these and other policy issues, contact Larry Goolsby, director of legislative affairs, or see the APHSA web site at www.aphsa.org.

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