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LSA Washington – December 20, 2011

A regular publication from the LSA Public Policy Office

LSA Member Fairview Health Services Announced as Pioneer Accountable Care Organization

On December 19, HHS Secretary Kathleen Sebelius announced that 32 leading health care organizations from across the country will participate in a new Pioneer Accountable Care Organizations (ACOs) initiative made possible by the Affordable Care Act. Fairview Health Services in Minneapolis, MN, an LSA organization, is among the 32 organizations that underwent a rigorous competitive selection process by the Innovation Center, including extensive review of applications and in-person interviews. The first performance period of the Pioneer ACO Model will begin January 1, 2012.

The Pioneer ACO initiative will encourage primary care doctors, specialists, hospitals and other caregivers to provide better, more coordinated care for people with Medicare and could save up to $1.1 billion over five years. Under this initiative, operated by the Centers for Medicare & Medicaid Services (CMS) Innovation Center (Innovation Center), Medicare will reward groups of health care providers that have formed ACOs based on how well they are able to both improve the health of their Medicare patients and lower their health care costs.

The Pioneer ACO initiative is just one of a menu of options for providers seeking to better coordinate care for patients and use health care dollars more wisely. The Pioneer ACO model is designed specifically for groups of providers with experience working together to coordinate care for patients.  The Medicare Shared Savings Program and the Advance Payment ACO Model, both announced in October 2011, are also ACO options for providers.  More information about the full menu of options for providers and how to apply to participate is available HERE.

For the final list of participating Pioneer ACOs and more information about the Pioneer ACO Model, a fact sheet is posted HERE or you can visit:

The Pioneer ACO Model is one of several initiatives underway at CMS designed to support the formation of ACOs.  For more information, visit For more information about the CMS Innovation Center, visit

FY 2012 Spending Package Cleared for President’s Signature

Over the weekend, Congress approved legislation to fund the federal government through the end of fiscal year 2012. The $915 billion “megabus” package adheres to the budgetary caps set by the Budget Control Act over the summer. The final package completes the work on the fiscal 2012 appropriations bills. It includes the text of the underlying Military Construction-VA bill and eight other spending measures: Defense, Energy-Water, Financial Services, Homeland Security, Interior-Environment, Labor-HHS-Education, Legislative Branch and State-Foreign Operations. In November, a “minibus” (PL 112-55) containing the other three annual spending bills was enacted.

The deal on the final package had largely been settled by December 12, but Senate Democratic leaders delayed scheduling a vote over concerns that Republicans might leave town without extending the payroll tax cut. The president is expected to sign the omnibus spending package this week.

While lawmakers said they were pleased that all 12 spending bills would be enacted this year, there is widespread frustration that none were able to clear Congress in regular order. The House was able to pass six stand-alone bills, while the Senate only advanced one. Congress has not cleared all 12 spending bills individually since 1996, but most years at least some bills move outside year-end spending packages. Leaders and senior appropriators said they would push to move more individual bills next year, but that will be a tall order in an election year.

Source: BNA Daily Tax Report, The Hill, Congressional Quarterly

More Federal Agency News and Announcements

VA Announces $100 Million in Grants to Assist Homeless Veterans. The Department of Veterans Affairs (VA) has announced that $100 million has been made available to community agencies to assist very low-income veterans and families facing homelessness. These funds are offered through the Supportive Services for Veteran Families (SSVF) program, a homeless-prevention and rapid re-housing program. The “Notice of Funding Availability” and applications are available on the VA website at

In December and January, VA is sponsoring free workshops to review grant applications for community organizations interested in applying for funds under this program. The workshops will be held in Atlanta, Baltimore, Denver, Oakland, and Kansas City. Click HERE for locations, dates, and the registration form, and click HERE to download presentation materials.

ALL QUESTIONS should be referred to the SSVF Program Office via toll-free number at 877-737–0111 or via email at

Obama Administration Announces New Labor Rules for Home Care Workers. On December 15, Secretary of Labor Hilda Solis announced a proposed rule from the U.S. Department of Labor to revise the Fair Labor Standards Act rules to include approximately 1.8 million workers who provide in-home care services for the elderly and infirm. The new rule would apply minimum wage and overtime protections.

In-home workers were exempted from the Fair Labor Standards Act protections in 1974. At that time, the intent was to exempt babysitters and “companions” to the elderly and people with disabilities, whose activities were not expected to be long term or involving more complex care.  Since then, a rapidly growing industry has arisen to meet the needs of our aging population.  Of the 1.8 million home care workers, 1.6 million work through agencies. 

The new rules will apply to all in-home workers hired through agencies and to those workers hired directly by families to perform skilled caregiving.  Those hired by families for companionship (engaging in hobbies, for instance) will still be exempt from the FLSA protections.

While some states provide minimum wage and/or overtime protections to home care workers under their own laws, 29 do not.  According to the Obama Administration, nearly half the nation’s home care staff work in these states.

Once published, comments are encouraged by visiting the federal rulemaking website at More information, including the proposed rule and fact sheet, is available HERE.

Source: Coalition on Human Needs

Proposed HOME Regulations Offer Significant Changes to Current Rule. The long-awaited proposed changes to the HOME program regulations were published in the Federal Register on December 16. The proposed rule contains considerable revisions. More about some of the proposed changes can be found HERE.

The December 16 proposed rule is available HERE. Comments on the proposed regulations are due February 14, 2012.

General information about the HOME program is on page 102 of National Low Income Housing Coalition’s 2011 Advocates’ Guide HERE

Source: National Low Income Housing Coalition

IRS Announces Standard Mileage Rates for 2012. The Internal Revenue Service announced December 9 the standard mileage rates for taxpayers to use in computing cost deductions for business, charitable, and medical / moving purposes for the 2012 tax year. Beginning January 1, 2012, the standard mileage rates for the use of cars, vans, pickups, or panel trucks will be: 55.5 cents per mile for business miles driven; 23 cents per mile for medical or moving purposes, down 0.5 cents from the 2011 mid-year adjustment; and 14 cents per mile for services to charitable organizations. The IRS has the authority to adjust volunteer mileage rates for business and medical/moving purposes, but not for charitable activities, which can only be adjusted through legislation and has remained unchanged since 1997.

Source: BNA Daily Tax Report

New Research and Information Available

New Analysis of Home Health and Personal Care Aides. PHI has published an in-depth analysis of the largest and fastest-growing workforce in the nation -- the 2.5 million home care and personal assistance aides who provide long-term services and supports to elders and people living with disabilities in home and community-based settings. The report, Caring in America -- A Comprehensive Analysis of the Nation's Fastest-Growing Jobs: Home Health and Personal Care Aides, uses the best data and research available today to present the most complete picture of the home care workforce possible.
For more information on the direct-care workforce, including the PHI State Data Center, Chart Gallery with downloadable graphs and charts, and Fact Sheets, visit PHI PolicyWorks.

2010 Child Abuse Data Shows Little Change. The 2010 data from the National Data Archive on Child Abuse and Neglect (NDANDS) has been released, and it shows similar numbers to 2009. Overall, there were 3.3 million reports of child abuse and neglect covering 5.9 million children. Of that total, 754,000 children were substantiated as having been neglected or abused. Since last year, the report has been reporting unduplicated counts, and the number of unduplicated children substantiated were at 695,000 (a duplicated count will count the same child more than once if that child was reported more than once in the year). Seventy-eight percent of children were substantiated as victims of neglect, 17.6 percent were substantiated as victims of physical abuse and 9.2 percent were substantiated as victims of sexual abuse (the totals come to more than 100 percent because some children may be substantiated for more than one form of abuse or neglect). In a statistic particularly relevant at this time, three-fifths of reports for abuse and neglect were filed by professionals. The three largest sources of reports were by teachers (16.4 percent), law enforcement including legal professionals (16.7 percent) and social services staff (11.5 percent). To read the complete report with data, click HERE.

Information from Children in Foster Care Summit Now Available. On November 3 and 4, the Departments of Health and Human Services and Education held a conference on children in foster care and their education needs. The event or summit brought together representatives of all 50 states with each state sending an official from their child welfare agencies, education department and courts. The event and the efforts are the direct result of the Fostering Connections to Success Act (PL 110-351), which directed state child welfare agencies to assure access to ongoing education for children in foster care. The law requires a child in foster care to have the ability to remain in his or her same school if in their best interest or to receive immediate enrollment in a new school if a move is required. The event was summarized by representatives from the National Working Group on Foster Care and Education, a coalition of groups that have been working for several years to address the high education hurdles children and youth in foster care face. For the summit program, click HERE. And for the summit summary, click HERE.

New Report on Aging in Place. Aging in Place: State Livability Policies and Practices by Jana Lynott, Wendy Fox Grage, and Rodney Harrell highlights state land use, housing and transportation policies and practices that promote aging in place. Written and released jointly by AARP and the National Conference of State Legislatures, the report includes these major findings:

  • Land Use: Certain land use policies can help older adults live closer to or within walking distance of the services they need.
  • Transportation: Increased mobility options can reduce reliance on transportation by personal car.
  • Housing: Affordable, accessible housing can decrease institutionalization and meet consumer demand.

The report also includes promising state practices in each of these areas.

Publication Commemorates Anniversary of U.S. Special Committee on Aging. The Fall 2011 Issue of Public Policy & Aging Report (PPAR) is dedicated to the 50th anniversary of the U.S. Senate Special Committee on Aging. Over the years, the committee has called attention to pressing needs facing older Americans. Articles describe the challenges and opportunities that lie ahead. The issue is supported in part by The SCAN Foundation. To read the PPAR fall 2011 issue, "America's Opportunity: The Potential of an Aging Society," please click HERE.

Bills to Extend TANF Pass House, Senate

On December 13, the House approved, 234-193, the Middle Class Tax Relief and Job Creation Act (H.R 3630). The measure contains provisions to extend through FY2012 Temporary Assistance for Needy Families (TANF) grants for family assistance, healthy marriage promotion and responsible fatherhood, and tribal assistance, among other programs. The bill also would authorize $2.917 billion for child care entitlement programs.

Among other provisions, H.R. 3630 would require states receiving TANF funds to maintain policies and procedures that prevent TANF assistance from being used in casinos, liquor stores, and strip clubs. States that fail to do so within two years of enactment would have their state family assistance grant funds reduced by five percent for the following year and each year in which the state does not implement such practices.

On December 15, the House approved, by voice vote, the Welfare Integrity and Data Improvement Act (H.R. 3659), which was incorporated into H.R. 3630.

On December 17, the Senate approved, by unanimous consent, a version of H.R. 3630 that would extend the TANF program through February 29, 2012. In September, Congress cleared a temporary extension (P.L. 112-35), which will expire on December 31.

Source: Women’s Policy, Inc.

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