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What’s in Store for the OCSE’s National Child Support Enforcement 2010-2014 Strategic Plan?

Last week,at the National Child Support Enforcement Association (NCSEA) Policy Forum and Training Conference, the final Session highlighted proposed ideas and directions for child support enforcement (CSE) for the upcoming year to facilitate improved services. Nancy Thoma Groetken, Regional Program Manager for the Department of Health and Human Services, Administration of Children and Families, Office of Child Support Enforcement (OCSE), revealed that modifications had been made towards objectives and that CSE would be more integrated, with the new strategies. A major component of the change involves expansion of the program along with the vision and mission. The strategies are expected to flow from OCSE's new mission: to enhance the well-being of children, and secure avenues in obtaining support for children, including financial and medical. Groetken made sure to point out that the program's mission, are still tentative, and could change as a result of federal health insurance and TANF Reauthorization legislation.

Collaboration was highly touted throughout the Policy Forum, and as a result, came as no surprise when incorporated in the strategic plan. The technique is for agencies to essentially combine services and resources as a way to enhance the quality of services and strengthen families. Particularly, since child support departments overlap with other agencies such as Employment, and Health, it only seems practical to join forces and share knowledge since a lot of their customers are the same. Pam McKee, Planning and Evaluation Manager of the Michigan Department of Human Services, Office of Child Support (DHS/OCS) shared how her department collaborated with their state's Medicaid and Children's Health Insurance Program (CHIP). The agencies have several initiatives they all work on jointly, and utilize a "just in time" attitude, as McKee described. Michigan received a Special Improvement Project (SIP) grant which they used to develop a shared data view system with their Medicaid agency. The system developed cleanup reports that they were able to share amongst their counties. McKee stated that the state does not want to stop there, and will continue to make more efforts towards improving agency collaboration.

Other plans stressed for the future of CSE included the delivery of timely, clear and accessible services adapted to customer needs and circumstances. The use of electronic payment options was also highlighted, in addition to the idea that technology is essential in streamlining many CSE processes. Early intervention and proactive case management was also part of the future strategies including easier access to genetic testing for parents of kids born out of wedlock, and the design of case management tools and programs to ensure regular, consistent payments. Automation was also suggested as a way to manage case-closure effectively. Another interesting factor brought up, was the issue with currency exchange and electronic payments from state to state, and intricacies that ensue. Moreover, this would also be used when responding to cases on an international level as well.

Furthermore, with the new focus on cost-effectiveness and other performance measures to determine how well child support agencies are doing, technology is a key player for the future of CSE. Vendors should explore ways in which technology can be used to enhance the child support program's infrastructure that satisfy the CSE future goals and vision. With that being said, systems must be designed that guarantee efficiency, accountability, and quality case management in order to effectively assess performance and increase funding for further CSE initiatives.

Using Performance Measures to Assess Quality in Child Support Enforcement

The technique of using performance measures as a way to assess the quality in various child support programs and assist in levels of funding was another major topic examined in the 2010 National Child Support Enforcement Association (NCSEA) Policy Forum and Training Conference. It was argued that much of the child support enforcement (CSE) expenditure was not going towards cost-effective measures. The idea was that more support would be seen on the state and local level if more incentives were available. Performance measures would essentially be a way to provide evidence of the quality of work being done within these programs. David Stillman, IV-D Director of the Washington Division of Child Support, supported the idea stating that CSE should be a cost-effectiveness ratio exercised by child support workers. He emphasized the importance of CSE in families and how there should be a reflection of the impact. The idea of performance measures seemed to be a widely accepted theme in the conference even amongst tribal communities. Carleen Anderson, Council Member of the Colville Tribes stated that tribes are more than willing and happy to agree to performance measures. Her only was concern was that decision makers would be mindful and cognizant, in their evaluation, of their unique environment in which they do business, since it significantly differs from that of a state.

Performance could be evaluated in a variety of ways such as the outcomes of child support prevention programs, as seen in ones such as the Parenting and Paternity Awareness Program (PAPA) executed in Texas. Other performance measures could be evaluated with the help of technology. Many states are reconsidering the ways in which data from CSE is being incorporated into their systems, and making upgrades and modernizations accordingly. For example, Pam McKee, Planning and Evaluation Manager of the Michigan Department of Human Services, Office of Child Support (DHS/OCS), revealed a few technology challenges her state had overcome. She stated that recent system changes enabled streamlining of medical support, payment process screens and data exchanges. McKee also revealed that her state's shared agency data view system, developed for cleanup reports, is currently experiencing technical problems and is being considered for revisions.

A representative from New York, Lee Sapienza, Chief of Policy, Planning and Data Analysis shared information about their state's IV-D system that interfaced with Medicaid and the (IV-D) program. The state had experienced problems with the system, including cases where there were no distinguishing codes for Medicaid services, which led to an influx of broad-ranged referrals. A system was then developed, that aligned more with the characteristic codes, in which numbers are run on a nightly basis. The system also assists in notifying the Medicaid program when they get private health insurance in Medicaid-related cases, in which Medicaid does additional matching. Sapienza stated that the state may make more upgrades to the system that will incorporate an interface that includes federal notifications as well.

Kim Newsom Bridges, Executive Director for the Ohio CSEA Director's Association, shared how Ohio had recommendations in July 2008, for improving their CSE system that would get their software up to speed. Bridges stated that the state was doing a fairly good job of getting their child support program into the implementation stage and that the main motivation for making the revisions, and as quickly as possible, was to reach cost-effective solutions and alleviate financial challenges.

Other initiatives to increase efficiencies, discussed in the Policy Forum included the idea that there must be a more uniform process for processing clients and managing cases, and essentially the development of a simplifies system across the state. States seemed to uphold these ideas including San Diego California, who just received a lot of stimulus funds, and plans to move to an electronic interface between TANF and CSE. Further, Louisiana plans on building out an interface that will utilize data-driven decisions and facilitate capacity in their CSE caseloads.

Overview of the NCSEA's 2010 Policy Forum and Training Conference

The 2010 National Child Support Enforcement Association (NCSEA) Policy Forum and Training Conference, was held January 25-27, 2010 in Washington, DC. NCSEA serves child support professionals, agencies, and strategic partners worldwide through professional development, communications, public awareness, and advocacy to enhance the financial, medical, and emotional support that parents provide for their children. The Policy Forum and Training Conference held annually, is a way for the child support community and partners to come together and discuss major issues in Congress and new ways of practice implemented throughout the nation. The theme of the Policy Forum this year was, "The Changing Faces of Families".

The main focus of the conference revolved around shifting the Child Support Program's (CSP) vision, towards avenues such as prevention, agency-collaboration and advancements in technology. The Conference brought in professionals and representatives from each state with varying subject matter expertise. The Conference consisted of seven Plenarys where a panel of representatives shared insight on various issues from policy changes affecting the Child Support Program to collaboration and implementation strategies states should be taking into consideration.

The Conference began with a general overview of child support, highlighting current issues. Much attention was paid to the verity that the spotlight must ultimately be placed on the child. Emphasis went towards the importance of child support in low-income custodial families and the reality of CSE reaching more people when compared to any other program. The first plenary also spoke about what the Temporary Assistance for Needy Families (TANF) Reauthorization would mean for CSE. Funding seemed to be a key concern for CSE, in which having enough money to execute the bill was a burning matter. Attention was given on the need for improvement with TANF, a program in dire need of increased funds. Surprisingly enough, funding for TANF has not increased since 1996, and states have responded to this by holding on to funds in order to prolong its use. The lack of funding provided through TANF disallows execution of programs designated for training and education. The Plenary went on further to talk about how TANF must be the entry point for parents to access jobs, trainings, and strategies, and how techniques must be explored to align program goals.

Yvette Riddick, Deputy Director from the Division of Policy for the U.S. Department of Health and Human Services, Administration for Children and Families, Office of Child Support Enforcement, (DHHS/ACF/OSCE) stated the mission of the Office of Child Support Enforcement (OCSE) was to locate parents, establish paternity and enforce orders. OCSE serves as a gateway to these services for 1 in 4 kids in the country.

Riddick highlighted Six Domains that must be considered in the improvement CSE:

  1. Prevention
  2. Engagement of Fathers from Birth
  3. Economic Stability Strategies
  4. Health Family Relations
  5. Healthcare Coverage
  6. Family Violence Collaboration

Other issues on OSCE's radar for 2010 included termination of the $25 Child Support Collection fee, deeming it unfair, and the costs of births under the Medicaid Program.

FY2011 Budget Request Offers Modest Increase for IT

This morning at 10am, half a dozen GovWin analysts sat waiting for the President's 2011 Budget Request to be posted. Toggling back and forth between the Office of Management and Budget and the Government Printing Office's websites, we saw the documents being posted one by one. After lamenting the fact that sadly, this is what makes research analysts giddy in the morning, we began poring through the budget documents to get a sense of priorities, cuts and surprises.

We're still at work (and will continue to be for the weeks to come), but I thought I'd share some of the highlights:

Total Budget:$3.8T

Total Discretionary Budget: $1.4T

Top 10 Department Base Discretionary Funding (with % increase/decrease over FY10 enacted funding):

  1. Defense - $548.9B (+3%)
  2. Health and Human Services - $83.5B (-1%)
  3. Transportation - $77.6 (+2%)
  4. State - $58.6 (+16%)
  5. Veterans Affairs - $57.0B (+7%)
  6. Education - $49.7B (+6%)
  7. DHS - $43.6B (+11%)
  8. HUD - $41.6B (-5%)
  9. Energy - $28.3B (+7%)
  10. Agriculture - $23.9B (-4%)
Program Terminations, Reductions, and Savings:
  • Termination:EP-X Manned Airborne Intelligence Surveillance Reconnaissance Aircraft (DoD) (-$12M)
  • Termination:Third Generation Infrared Surveillance Program (DoD) (-$73M)
  • Termination:Net Enabled Command Capability (DoD)(-$9M)
  • Termination:Unconventional Fossil Technology Program (DOE) (-$20M)
  • Reduction: Expeditionary Fighting Vehicle (DoD) (-$50M)
  • Reduction: Homeland Security Activities (EPA) (-$35M)
  • Reduction: Information Technology Efficiencies and Strategic Sourcing (DOI) (-$20M and -$30M respectively)
  • The administration also identified $72M in savings from various activities such as streamlining administrative support, using more videoconferencing capabilities, powering off computers, and (my favorite) "Optimizing Cellular Airtime."

    This round of releases did not include OMB's Exhibit 53, Report on Information Technology, however the total IT funding request is $79.4B (excluding legislative, judicial, intel and government-run organizations, which we include in our forecast). We also have a glimpse into some of the IT priorities, which include:

  • Cloud Computing - no surprise here
  • Data Center Consolidation
  • Health IT
  • Geospatial
  • Centralizing IT Acquisition
  • Using IT to improve service delivery
  • Centralizing IT Acquisition
  • GovWin's Federal Industry Analysis team is hard at working analyzing the budget request. Check back soon for a more detailed report.

    Starting off the New Year Strong: The Health Care and Social Services Market in January 2010

    The state and local health care and social services industries started off the first month of the New Year with feverish intensity--from outlining plans for statewide health information exchange (HIE) projects to engaging in Women, Infant, and Children (WIC) Electronic Benefit Transfer (EBT) state feasibility studies. Despite lingering budget deficits that will continue to impact the upcoming fiscal year, some states are still able to move forward with information technology (IT) projects that are revenue generating and/or more cost effective.

    Around the industry, January brought forth two major business agreements. Accenture and Oracle have joined forces to develop integrated software packages to address the needs of state social services agencies and their rising workloads. The collaborative child welfare case management solution is based in part on Oracle's Siebel CRM Public Sector Case Management commercial-off-the-shelf (COTS) product, Oracle's Policy Automation rules engine, and Accenture's current child welfare solutions. The second business deal was Unisys agreeing to sell its health information management business to Molina Healthcare for $135 million. The deal is expected to close in the first half of 2010. Unisys currently contracts with several states, including West Virginia and New Jersey, providing Medicaid Management Information Systems (MMIS) and fiscal agent services. This is an interesting transaction, as Molina is a managed care provider. In other news, the California Regional Health Information Organization (CalRHIO) will be closing its doors after a failed attempt to be named the state designated entity. The state has elected to create a new entity to lead it's HIE efforts. And midmonth the federal U.S. Department of Health and Human Services (DHHS) released the proposed rule for the provider electronic health record (EHR) incentive program. The Centers for Medicare & Medicaid Services (CMS) is currently accepting comments from stakeholders on all issues set forth in the proposed rule.

    GovWin released two blogs for the 2010 top initiatives in both the health care and social services sectors. The health care line-up exceeds an estimated $780 million in potential contracting opportunities and includes projects such as the highly anticipated New York Medicaid Management Information System and the Oklahoma HIE. On the social services side, investments total an estimated $243 million in IT spending. Topping the list is the California Child Support Maintenance and Operations project, as well as, the Florida Unemployment Compensation Modernization initiative. In addition, GovWin hosted a webinar on statewide HIEs and the $564 million in economic stimulus funding that is being used to accelerate network implementation efforts. Slides and the recording can be downloaded here.

    Below is some notable contracting activity:

    • The New York Office of Children and Family Services (OCFS) released the Child Care and Attendance Payment System Request for Proposals (RFP) in the beginning of the month.
    • The Ohio Health Information Partnership (OHIP) released a Request for Information (RFI) seeking information on full service HIE solutions that best fit the state's requirements.
    • Iowa's Department of Public Health released an RFI for the development of a Business and Financial Plan for Iowa e-Health. Responses are due by February 16, 2010.
    • The State of Tennessee Department of Labor and Workforce Development released a RFP for the Procurement of Vendor Services to Assist the Southeast Consortium in Conducting a Study to Define and Evaluate a Planned Approach to Collaboratively Develop an Unemployment Insurance (UI) Benefit System and to Present Findings of this Study. To review the forecasted UI Benefit System please go here.
    • Capgemini Government Solutions, LLC was awarded the Unemployment Insurance Modernization contract with the Nevada Department of Employment, Training and Rehabilitation (DETR) in the amount of $27,943,902.
    • The California Department of Health Care Services (DHCS) awarded ACS State Healthcare, LLC the MMIS and fiscal agent contract. The contract is valued at $1.4 billion.
    • The Minnesota Department of Human Services confirmed they awarded the Food Stamps EBT contract to eFunds. The contract will run from May 1, 2010, to April 30, 2015.