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1994.09.26 : Welfare and Health Care Demonstrations

Contact:  Melissa Skolfield   (202) 690-6853

         SECRETARY SHALALA ANNOUNCES PRINCIPLES FOR REVIEW 
              OF WELFARE AND HEALTH CARE DEMONSTRATIONS


     HHS Secretary Donna E. Shalala announced policies and
procedures today that will guide the department when reviewing state
waiver requests under the Aid to Families with Dependent Children
and Medicaid programs.  

     The policies and procedures are designed to streamline and
afford public comment in the review process for health and welfare
reform proposals by the states.  They will be published in the
Federal Register Tuesday.

     The department's "section 1115" waiver authority allows the
approval of selected state welfare reform and health reform
demonstration programs.  In August 1993, HHS adopted internal
policies defining the criteria for review of waiver requests.  
These principles have guided the department's review and approval of
18 AFDC demonstrations and six statewide health reform projects
since the Clinton administration took office.

     "State flexibility is key to our efforts to test new ways to
improve the AFDC and Medicaid programs and we have already made
great progress in simplifying what had been a cumbersome process," 
Secretary Shalala said.  "We recognize, as well, that public
consultation can help states shape demonstrations that will allow us
to conduct our review and decision-making more quickly.  

     "These policies are designed to provide the appropriate public
input, speed up the process and maintain our commitment to provide
quality services to our beneficiaries."

     Tomorrow's Federal Register notice will publish the principles
adopted in August and build on them by involving the public in a
consultative process with the states prior to departmental review of
waiver requests.

     Under the policies, states have great flexibility in providing
the public opportunity to learn about and comment on the content of
a proposal.  Consultation may include public hearings or other
similar processes for public input.


     Each month the department will publish a notice in the Federal
Register of all new and pending proposals.  HHS will continue to
accept and consider written comments regarding demonstration
projects.

     The policies and procedures also affirm the department's
commitment to meaningful evaluations using a broad range of
appropriate evaluation strategies.  During a period of continuing
budgetary constraints, the department will maintain the policy of
cost neutrality, although cost neutrality is being assessed over the
life of the proposed demonstration program instead of year by year.

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