The Family First Transition and Support Act

Senators Sherrod Brown (D-Ohio) and Debbie Stabenow (D-Mich.) plan to introduce legislation in the Senate that would provide states with resources and funding flexibility during the implementation of Family First Prevention Services Act (FFPSA), which became law last year. This proposed legislation addresses some of the timing and funding concerns that child welfare advocates have expressed concerns over with FFPSA implementation. This bill would disconnect federal foster care money from an income test and ease the transition process of FFPSA. It is likely that it will be introduced next week and would include the following:

  • Eliminate the Title IV-E foster eligibility requirements for foster family homes tied to the 1996 Aid to Families with Dependent Children (AFDC) law;
  • Provide states more time to develop the research base for prevention programs they want to use by delaying the 50 percent well-supported requirement;
  • Provide funds for State-directed research to develop interventions to meet Family First evidenced-based requirements and help meet Family First licensing;
  • Boost funding for Regional Partnership Grants and child welfare Court Improvement Programs.

We have previously reported on another bill that would help ease the FFPSA transition. Senators Rubio (R-Fla.) and Feinstein (D-Calif.) introduced the “State Flexibility for Family First Transitions Act” in January. That bill would extend waivers for states receiving Title IV-E to allow greater funding and flexibility for foster care and child welfare recipients beyond the current federal baseline. Set to expire in September 2019, the legislation would extend the waiver by two years, which would allow states to receive an extension up until the full implementation of FFPSA. It would also require that states verify to HHS how they intend to use the extension to transition to the programs supported by FFPSA.

Both bills will be considered by the Senate Finance Committee.

Immigration Updates

Last week new Homeland Security Secretary Kevin McAleenan urged Congress to address the humanitarian and security crisis at the U.S.-Mexico border. McAleenan said that resources are being stretched thin and that the system is full and beyond capacity.  In other immigration news, the Department of Housing and Urban Development recently announced that they are working to prevent undocumented immigrants from receiving housing aid due to the millions of American citizens who are waiting for public housing.  

CMS Announces New Opportunities to Test Innovative Integrated Care Models for Dually Eligible Individuals (Medicaid and Medicare)

Earlier this week CMS sent a letter to State Medicaid Directors inviting states to partner to test out innovative approaches to better serve dual eligible populations (those eligible for both Medicare and Medicaid). This population (12 million) often has complex healthcare issues, including chronic conditions and socioeconomic risk factors that can lead to poor health outcomes. The current lack of coordinated care often leads to fragmented care for consumers and misaligned incentives for payers and providers, according to Administrator Seema Verma. Some of the approaches proposed in the letter include the Capitated Financial Alignment Model, Managed Fee-for-Service Model, and State-Specific Models.

HHS To Deliver Value-Based Transformation in Primary Care

The U.S. Department of Health and Human Services and Centers for Medicare & Medicaid Services announced a new payment model for primary care called the CMS Primary Care Initiative. The new system is said to transform primary care to deliver better value for patients throughout the healthcare system. This system will reduce administrative burdens and empower primary care providers to spend more time with their patients with the goal of reducing overall health care cost. Primary care will include two tracks that will offer providers varied degrees of risk-sharing to encourage population-based primary care. More information can be found here.

HHS Announced Next Steps in Advancing Interoperability of Health Information

On April 19, HHS issued for public comment a second draft of the Trusted Exchange Framework and Common Agreement (TEFCA) that would support network-to-network exchange of health information across the country. HHS focused on three high level goals – providing a single “on-ramp” to nationwide connectivity, ensuring electronic information securely follows you when and where it is needed, and support nationwide scalability for network connectivity. You can find more on this announcement here.

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