Administration for Children and Families (ACF)
The ACF, which has 10 regional offices, is responsible for federal programs that promote the economic and social well-being of families, children, individuals, and communities. Their mission is to empower people to increase their own economic well-being, support communities that have a positive impact on the quality of life of their residents, partner with other organizations to support Native American tribes, improve needed access to services, and work with special-needs populations. The ACF also has programs that target human trafficking and refugees ( ACF, 2016 ).
Centers for Medicare and Medicaid Services (CMS)
The CMS was established when the Medicare and Medicaid programs were signed into law in 1965 by President Lyndon B. Johnson as a result of the Social Security Act. At that time, only half of those 65 years or older had health insurance. Medicaid was established for low-income children, the elderly, the blind, and the disabled and was linked with the Supplemental Security Income program (SSI). In 1972, Medicare was extended to cover people under the age of 65 with permanent disabilities. The CMS also has oversight of SCHIP, Title XXI of the Social Security Act, which is financed by both federal and state funding and is administered at the state level.
Headquartered in Baltimore, Maryland, the CMS has over 20 offices that oversee different aspects of programs. The primary responsibility of CMS is to provide policy, funding, and oversight to healthcare programs for elderly and poor individuals. For many years, the CMS was a geographically based structure with 10 field offices. In 2007, it was reorganized to a consortia structure based on the priorities of Medicare health plans and financial management, Medicare fee for service, Medicaid and children’s health, surveys and certification, and quality assurance and improvement. The consortia are responsible for oversight of the 10 regional offices for each priority. In 2010, the Center for Program Integrity was developed as part of the CMS; it focuses on best practices for program implementation (CMS, 2016a). As part of the Affordable Care Act, the Innovation Center was established. Congress created the Innovation Center for the purpose of testing “innovative payment and service delivery models to reduce program expenditures while preserving or enhancing the quality of care” for those individuals who receive Medicare, Medicaid, or Children’s Health Insurance Program (CHIP) benefits. The CMS also oversees the ACA Health Insurance Marketplace (CMS, 2016b).