1. 1 Draft North Carolina Department of Health & Human Services Draft NC FAST Executive Status February 9, 2016

2. 2 Draft 2 AlamanceCaswellGrahamLeeNorthamptonSampsonWatauga AlexanderCatawbaGuilfordLincolnOrangeScotlandWilkes AlleghanyChathamHalifaxMaconPersonStanlyWilson AnsonClevelandHarnettMadisonPittStokesYadkin AsheCumberlandHaywoodMartinPolkSurryYancey AveryDavidsonHendersonMcDowellRandolph Swain BertieDavieHertfordMecklenburgRichmondTransylvania BuncombeDurhamHokeMitchellRobesonUnion BurkeEdgecombeIredellMontgomeryRockinghamWake CabarrusFranklinJohnstonMooreRowan Warren CaldwellGatesJonesNashRutherfordWashington Adverse weather conditions during the period of Jan. 20 th – Jan. 29 th forced offices in the following counties to either close for an entire day, close early, or delay opening at least once. As a result, application and recertification processing across programs may have been negatively impacted. Key Areas for Attention

3. 3 Draft 3 Key Areas for Attention DMA issued an administrative letter on December 17, 2015 providing counties the background and criticality of working the unconverted cases in NC FAST. As of February 1, 2016, there were 691 EIS cases not fully converted in NC FAST: County# of Cases Bladen1 Buncombe3 Davidson1 Guilford1 Harnett504 Hoke1 Iredell1 Mecklenburg98 Person1 Randolph72 Rockingham1 Union1 Wake6 TOTAL691

4. 4 Draft Key Areas for Attention NC FAST System Issues: IBM has worked with NC FAST Architecture & Infrastructure (A&I) team to identify suggest system changes: 1) Alignment of the WAS Connection pools on the app servers to fit within the total available database connections (Status: Change was made by NC FAST team 1/28/2016) 2) IBM Product Development engaged / reviewing current trace / system information 3) IBM identification of expired data in database that is generating deferred processes (Status: Changes in test, scheduled for deployment this weekend) 4) NC FAST to deploy Dynatrace application monitoring tool (Status: NC FAST working on plan to deploy as early as this weekend) 5) IBM working on deployment of additional resources to assist in problem determination with NC FAST - Websphere support contacted / working availability to be on site at NC FAST - Cúram Application Level 2 Support (planned remote) - Cúram PD Assistance (Request to be on call in addition to Cúram Level 2 engaged) 6) Health Check of Environment (Status: Schedule for Health Check being worked / Expect date solidified by end of week) 7) NC FAST – Request tracking / daily reporting of 15 minute window of WAS Connections pools to Apps and DBs 8) NC FAST – Will provide executive management system availability metrics Draft 4

5. 5 Key Areas for Attention USDA FNS Timeliness USDA Timeliness Requirement: A 95 percent average statewide timeliness rate for completed FNS applications for the 6 month period from January 2016 through June 2016 Timeliness defined as receiving benefits within 7 days of application for expedited applications and within 30 days for normal applications NC FNS policy was updated to require that expedited applications be processed by the 4 th day and normal applications be processed by the 25 th day. This increases the probability that a household will have access to benefits by the 7 th and 30 th day (allowing time for issuance and distribution of new EBT cards, as needed.) Quality Control (QC) Process – as outlined by USDA: Cases pulled in a random QC sample are manually evaluated by QC Performance Management Section based on the availability of benefits by the 7th and 30th day (not the 4th and 25th day.) Results from these samples are considered as the official timeliness measure by the USDA. Current Rates Based on NC’s QC Process (Random Sample): Cumulative rate July 2015-September 2015: 84.26% Weekly Rate Based on NC’s USDA Reports (All Applications): For the week of 01/25 -01/29, the rate is 90.64%. Draft 5

6. 6 FNS Issuances Over Time 1 Nov 2013 ARRA funding was removed by policy. 2 Oct 2014 Benefits increased based on Federal COLA adjustments.

7. 7 Draft Statewide Total 90.64%7,8029.36%80693.85%4,7926.15%31485.95%3,01014.05%492 Total 81.55%1,49018.45%33787.23%92912.77%13673.62%56126.38%201 *Note: See slide 2 for definitions related to FNS timeliness. All ApprovedNot ExpeditedExpedited TimelyUntimelyTimelyUntimelyTimelyUntimely PctCountPctCountPctCountPctCountPctCountPctCount Martin 71.43%2028.57%892.86%137.14%150.00%7 7 Pamlico 73.33%1126.67%487.50%712.50%157.14%442.86%3 Jones 73.91%1726.09%687.50%1412.50%242.86%357.14%4 Rockingham 76.39%5523.61%1786.84%3313.16%564.71%2235.29%12 Cumberland 78.73%32221.27%8778.11%18221.89%5179.55%14020.45%36 Camden 80.00%420.00%175.00%325.00%1100.00%10.00%0 Wake 81.06%36818.94%8684.91%24215.09%4374.56%12625.44%43 Burke 81.54%5318.46%1293.94%316.06%268.75%2231.25%10 Hoke 82.54%5217.46%1191.89%348.11%369.23%1830.77%8 Caswell 83.33%1516.67%3100.00%70.00%072.73%827.27%3 Hyde 83.33%516.67%1100.00%40.00%050.00%1 1 Granville 83.72%3616.28%782.76%2417.24%585.71%1214.29%2 Surry 83.93%4716.07%978.26%1821.74%587.88%2912.12%4 Yancey 84.21%1615.79%3100.00%120.00%057.14%442.86%3 Durham 84.50%16915.50%3193.86%1076.14%772.09%6227.91%24 Henderson 85.14%6314.86%1192.31%487.69%468.18%1531.82%7 Union 85.22%9814.78%1793.85%616.15%474.00%3726.00%13 Iredell 85.44%8814.56%1596.55%563.45%271.11%3228.89%13 Clay 85.71%614.29%1100.00%40.00%066.67%233.33%1 Scotland 86.54%4513.46%7100.00%290.00%069.57%1630.43%7 Draft 7 Weekly FNS Processing Timeliness (Snapshot): Most Impacted Counties (USDA 7 day/30 day Timeliness) Data reflects Jan. 25 th – Jan. 29 th. This data reflects a weekly snapshot and will change week to week. This is not a cumulative view. **Note: 71 counties had office delays or closings due to winter weather during the period of Jan. 20-29.

8. 8 Draft Statewide FNS Application Processing Timeliness (USDA 7 day/30 day Timeliness) Running Weekly Application Processing Timeliness Rate: 8 Data as of January 29 th – Reporting based on all applications processed (not the QC sample). 11/16-11/2011/23-11/2711/30-12/0412/07-12/1112/14-12/1812/21-12/2512/28-01/0101/04-01/0801/11-01/1501/18-01/2201/25-01/29 Approved Timely 7,1274,8138,3129,2338,8484,0055,0589,8549,1166,6347,802 Total Approved 8,1265,6619,27910,1849,7674,4545,70810,75310,0247,4488,608 Rate 88%85%90%91% 90%89%92%91%89%91% *Note: See slide 2 for definitions related to FNS timeliness. **Note: 71 counties had office delays or closings due to winter weather during the period of Jan. 20-29.

9. 9 Draft Potential Untimely FNS Applications- Most Impacted Counties (NC FNS Policy of 4 day/25 day Timeliness) County Total Potential Untimely Pending FNS Applications (as of 2/3) Total Potential Untimely Pending FNS Applications (as of 1/27) Total Potential Untimely Pending FNS Applications (as of 1/20) Total Potential Untimely Pending FNS Applications (as of 1/13) Wake 1338649111 Mecklenburg 1017145141 Cumberland 94752756 Durham 68342050 Forsyth 65402646 Robeson 63413643 Guilford 43271039 Gaston 38261230 Hoke 36221321 Rowan 3517528 Iredell 34211427 Pitt 3215718 New Hanover 3018931 Alamance 2616919 Onslow 254624 Union 2414818 Henderson 207711 Orange 202415 Catawba 199614 Davidson 1991024 TOTAL925554323766 Statewide1,3518185201,165 Draft 9 *These pending applications have been outstanding longer than the allotted time; however, for applications that will be denied, the step of denying the application must be held by rule to happen after the fully allotted processing timeline. As such, not all of the total applications represented in these counts will ultimately be considered untimely. *Note: 71 counties had office delays or closings due to winter weather during the period of Jan. 20-29.

10. 10 Draft County Total Untimely Pending FNS Recertifications (as of 2/3) Total Untimely Pending FNS Recertifications (as of 1/27) Total Untimely Pending FNS Recertifications (as of 1/20) Total Untimely Pending FNS Recertifications (as of 1/13) Wake 3,5551,5672,0872,072 Mecklenburg 1,977148367873 Wayne 67799194247 Durham 551130224311 Forsyth 520165498 Union 42245136213 Guilford 3005124 Scotland 2902041121 New Hanover 228925106 Hoke 152183865 Rockingham 14671040 Rowan 6882734 Pender 50014 Stanly 48030 Onslow 45026 Moore 446910 Gaston 325710 Cabarrus 23113 Davidson 20104 Lenoir 17355 TOTAL9,1652,0883,2434,226 Statewide9,4182,1413,3094,312 Untimely FNS Recertification Workload Snapshot: Most Impacted Counties *Reminder- Untimely FNS Recertification numbers spike at the beginning of each month and are worked down throughout the month. Draft 10 **Note: 71 counties had office delays or closings due to winter weather during the period of Jan. 20-29.

11. 11 Draft Special Assistance Issuances 11 *Note: Minimal payments (less than 0.05% of the total dollar value) were made from the legacy system during these months and those payment counts are not included here.

12. 12 Draft Work First Issuances 12 *Note: Minimal payments (less than 0.05% of the total dollar value) were made from the legacy system during these months and those payment counts are not included here.

13. 13 Draft Refugee Assistance Issuances 13

14. 14 Draft Overall Medicaid Applications Processed Overall Medicaid Apps includes Adult Medicaid (includes SDX), Traditional Family and Children’s Medicaid, and MAGI Family and Children’s Medicaid (including those from HealthCare.gov). *Data as of February 3 rd **Working with DHHS IT, the quarterly SDX catch-up process was refined beginning in October. Quarterly update volumes seen in April and July 2015 are not expected going forward. Draft 14 ***Note: 71 counties had office delays or closings due to winter weather during the period of Jan. 20-29.

15. 15 Draft Adult Medicaid Applications Approved *Data as of February 3 rd **Application counts increased in Dec 2014 because this is the point at which SDX processing was fully transitioned from the legacy system to NC FAST. SDX did not create applications in EIS, but does in NC FAST. ***Working with DHHS IT, the quarterly SDX catch-up process was refined beginning in October. Quarterly update volumes seen in April and July 2015 (not shown to scale) are not expected going forward. Draft 15

16. 16 Draft NC-Based F&C Medicaid Applications Approved *Data as of February 3 rd **NC-Based F&C Medicaid Applications processed include Traditional F&C Applications and NC-Based MAGI F&C Applications. Draft 16

17. 17 Draft HealthCare.Gov F&C Applications Approved *Data as of February 3 rd **ACA Year 1 ended November 14, 2014. ACA Year 2 began November 15, 2014 and ended February 15, 2015. Special Enrollment Period for Tax Season: March 15, 2015 – April 30, 2015. ACA Year 3 began November 1, 2015. Draft 17

18. 18 Draft CategoryEnrollment AGED 124,539 BLIND 1,739 DISABLED 292,519 Medicaid Qualified Medicare Beneficiary (MQB-Q) 9,697 Medicaid Specified Low Income Medicare Beneficiary (MQB-B) 43,756 Medicaid Qualifying Individuals 1(QI1) (MQB-E) 21,393 Adult Medicaid Subtotal493,643 Temporary Assistance to Needy Families (TANF) UNDER 21471,347 TANF OVER 21195,027 OTHER CHILD5,610 PREGNANT WOMEN16,993 FAMILY PLANNING WAIVER106,634 INFANTS AND CHILDREN439,081 Breast and Cervical Cancer Medicaid (BCC)348 REFUGEES909 Family and Children’s Medicaid Subtotal1,235,949 Medicaid Child Health Insurance Program (MCHIP)116,646 Child Health Insurance Program (CHIP)82,607 CHIP- Extended Coverage3 North Carolina Health Choice (NCHC) Subtotal199,256 ALIENS-Documented11,581 ALIENS-Undocumented3 Other Subtotal11,584 TOTAL1,940,432* Medicaid Enrollment- February 2016 Notes: 1.NC FAST converted EIS single digit medclass code as a single digit medclass code. Once this case is touched by county worker, then NC FAST rules will rerun and yield a 2 digit medclass code. 2.Due to Affordable Care Act (ACA) changes, effective Jan 1, the following income is not counted - Child support, VA, Worker’s Comp. This affects Medical Assistance to Families with Dependent Children (MAF) / Medicaid for Infants and Children (MIC) / NCHC / State Foster Home Fund (HSF) / MFC (Foster Care). 3.Family Planning Waiver (MAF-D) will continue to grow during open enrollment because NC is not an expansion state and childless adults fall in this category. 4.NC FAST design does not allow county worker to choose a program (e.g., MIC). Rules within program logic decide the program. Unknown Category records occur when the rules choose a program not represented on the MA Enrollment Spreadsheet. These Unknown Category records are reviewed and investigated to help realign NC FAST assigned medclass codes to the traditional MA Enrollment Spreadsheet. *Numbers are tentative as minor variations are possible due to the retroactive change period. **Data as of February 3 rd Draft 18

19. 19 Draft ACA Year 1 (2013-2014)ACA Year 3 (2015-2016)  During Year 1 Open Enrollment (2013-2014), NC did not begin receiving applications from HealthCare.gov until January. This caused applications from Oct.-Dec. 2014 to accumulate, creating a burden for our counties. The chart represents the rate of client application submissions for better year to year comparisons.  For Year 2 Open Enrollment (2014-2015), NC received applications from HealthCare.gov as they were submitted, which helped create a more steady workload of HealthCare.gov applications. Year 2 included a Special Enrollment Period (SEP) from March 15 to April 30.  Year 3 Open Enrollment began Nov. 1, 2015. HealthCare.gov Medicaid Applications Received *Data as of February 3 rd Draft 19 ACA Year 2 (2014-2015)

20. 20 Draft HealthCare.gov Medicaid Applications Status Data as of February 3 rd ACA Year 1 (2013-2014)ACA Year 2 (2014-2015)ACA Year 3 (2015-2016) Status of Healthcare.gov/FFM Applications Application CountApplication %Application CountApplication %Application CountApplication % FFM applications received by NC FAST 86,93288,05051,720 Total FFM applications being processed 00%233.3%18,86136% Total FFM applications fully processed 86,932100%87,81799.7%32,85964% Applications approved for Medicaid ("woodwork effect") 9,00410%11,434 13%3,84212% Applications denied/withdrawn for Medicaid 77,92890%76,383 87%29,01788% Administrative Denial 7,0639%13,74818%5,36619% Already on Medicaid 12,44116%15,27720%8,13228% Withdrawn/ Found Ineligible 58,42475%47,35862%15,51953% 2015-2016 Open Enrollment Dates: November 1 st - January 31 st Approved: Applications approved for MAGI-based programs from the FFM Denied/Withdrawn: Applications denied for MAGI-based programs from the FFM (this includes duplicate applications, applicants already receiving Medicaid, applicants found ineligible, and out of state applications.) or applications that the applicant requested to withdraw. Draft 20

21. 21 Draft Pending Medicaid Applications *Data as of February 3 rd There are currently 11,280 pending Medicaid applications that are beyond standard processing time (Compared to 2014 peak of 104,070): HealthCare.Gov Applications: 5,209 (Compared to 2014 peak of 45,058) NC-Based MAGI Applications: 2,672 (Compared to 2014 peak of 31,890) Traditional Applications: 3,399 (Compared to 2014 peak of 20,938) Draft 21 **Note: 71 counties had office delays or closings due to winter weather during the period of Jan. 20-29.

22. 22 Draft Breakdown of Untimely Pending Medicaid Applications  There are 5,290 untimely pending Medicaid applications from the HealthCare.Gov.  There are 2,672 untimely pending Medicaid applications for MAGI Programs received online or in county DSS offices.  There are 3,399 untimely pending Medicaid applications in NC FAST for Traditional Programs. Draft 22 *Note: 71 counties had office delays or closings due to winter weather during the period of Jan. 20-29.

23. 23 Draft Untimely Pending Medicaid Applications- Most Impacted Counties Based on Volume County Total Untimely Pending Applications (as of 2/3) Total Untimely Pending Applications (as of 1/27) Total Untimely Pending Applications (as of 1/20) Typical Monthly Average # of Medicaid Applications Processed (2015) Total Apps Processed in Current Month (as of 2/3) Wake2,8522,2571,7295,534777 Mecklenburg2,1901,3637987,454929 Forsyth1,2181,0679722,363347 Randolph369362336840205 Pitt2652381771,059113 Iredell215202151904137 Guilford2061721182,964477 Rowan1871611371,006154 Durham184132881,837222 Cumberland1711851602,514333 Harnett171 163729105 Caldwell15714612661489 Union157120901,107170 Davie14812311423044 Gaston1251341061,506234 Onslow109104921,075150 Cabarrus10493611,162239 Davidson9880721,071183 Moore918879534145 Hoke80746637632 TOTAL9,0977,2725,63534,8765,085 *There will always be some applications that remain pending with good cause Draft 23 Of all Medicaid applications beyond the standard processing time, 81% are from 20 counties. **Note: 71 counties had office delays or closings due to winter weather during the period of Jan. 20-29.

24. 24 Draft Untimely Pending Medicaid Applications- Most Impacted Counties Based on County Size County Current Untimely Medicaid Applications as a % of Typical Monthly Application Volume Total Untimely Pending Applications (as of 2/3) Typical Monthly Average # of Medicaid Applications Processed (2015) Total Apps Processed in Current Month (as of 2/3) Davie64%14823044 Forsyth52%1,2182,363347 Wake52%2,8525,534777 Randolph44%369840205 Mecklenburg29%2,1907,454929 Avery28%279521 Northampton27%3713818 Pamlico26%3312610 Caldwell26%15761489 Pitt25%2651,059113 Polk25%2811439 Iredell24%215904137 Harnett23%171729105 Scotland22%7434249 Hoke21%8037632 Graham19%178816 Rowan19%1871,006154 Granville18%6134351 Moore17%91534145 Watauga15%2718236 TOTAL36%8,24723,0693,317 *There will always be some applications that remain pending with good cause. Draft 24 **Note: 71 counties had office delays or closings due to winter weather during the period of Jan. 20-29.

25. 25 Draft Medicaid Recertifications Processed  Historically, the pre-NC FAST average number of recertifications processed each month in EIS was 82,191. The average overdue recertifications per month was 7,166, and the average extended per month was 6,578.  Recerts not processed (shown in white on the graph) are recerts that have been extended to a later month to extend benefits while allowing time for processing to be completed. *Data as of COB February 3 rd **Family and Children’s Medicaid recertifications were auto-extended for 10 counties on the evening of January 19 th Draft 25 ***Note: 71 counties had office delays or closings due to winter weather during the period of Jan. 20-29.

26. 26 Draft Pending Medicaid Recertifications  A total of 125,062 Medicaid recertifications are pending through the end of February 2016. *Data as of COB February 3 rd **Family and Children’s Medicaid recertifications were auto-extended for 10 counties on the evening of January 19 th Draft 26 ***Note: 71 counties had office delays or closings due to winter weather during the period of Jan. 20-29.

27. 27 Draft Pending Medicaid Recertifications- Most Impacted Counties Based on County Size County Recerts Due in February (as of COB 2/3) as Percentage of "Typical" Monthly Average Total Recerts Due through February Past Due Recerts as of COB 2/3 "Typical" Monthly Average of Recerts Due Mecklenburg*250%32,7469,24313,109 Wayne*218%2,9831181,371 Harnett*207%3,2783311,585 Randolph*203%3,9503521,944 Vance136%93155684 Cabarrus133%3,0261,1472,268 Scotland*129%779145605 Wilson127%94972750 Wake*124%7,3021,1445,897 Sampson120%1,745321,452 New Hanover113%2,4161,2592,136 Cumberland113%4,5867164,065 Robeson112%3,0754002,746 Macon112%38588345 Pamlico111%1869167 Burke111%1,296451,164 Orange110%77035700 Greene108%21942203 Alamance106%2,5873242,449 Craven104%1,1613831,121 Total166%74,37015,94044,761 Statewide106%125,06223,640117,998  *Family and Children’s Medicaid recertifications were auto-extended for 10 counties on the evening of January 19 th. 27 **Note: 71 counties had office delays or closings due to winter weather during the period of Jan. 20-29.

28. 28 Draft 28 Medicaid Recertifications- Auto-Extended Counties  The following 10 counties had their Family and Children’s Medicaid recertifications auto-extended on the evening of January 19 th. 23,002 cases were extended: ForsythNorthampton GuilfordRandolph HarnettScotland HydeWake Mecklenburg*Wayne *Only MAGI cases were extended for Mecklenburg county.

29. 29 Draft 29 Draft Key System Metrics  NC FAST monitors key system metrics monthly, including: MetricDescriptionJuneJulAugSepOctNovDec System Availability Target is 99% or better system availability during scheduled uptime 99.6%100% Total Uptime Total uptime shown in hours 429448432423462415438 No. of Critical Incidents An outage that results in the entire NC FAST application not being available. Can also be a period of time during which system performance is degraded to the point normal business functions cannot be completed even though the system is available. 1000000 No. of Major Incidents An outage in which the NC FAST application is available, but one or more of the core functions provided by the application is not operable. 3202311 Notes 6/18: Required restart of database resulted in unplanned downtime for 108 minutes 6/3: NCID issue. 6/7: CNDS incident. 6/30: NCID issue. 7/9: NCID issue. 7/23: CNDS incident. 9/23: NCID issue. 9/28: NCID issue. 10/6: NCID issue. 10/7: NCID issue. 10/13: NCID issue. 11/4: Database and server issue. 12/31: NCID issue. Draft 29

30. 30 Draft Help Desk Tickets Open *Data as of February 3 rd **Data for previous months reflects the total number of tickets in each category as of the last day of that month. 30

31. 31 Draft Defect and CR Trend – Overall  There are currently 385 open High Defects in NC FAST. There are no open Critical or Major defects.  Change requests are worked by the application team in accordance with business priority. There are 33 high severity defects in testing for the next release (2/20/16-2/21/16). *Data as of February 3 rd

32. 32 Draft 32 Counties Requiring Attention *Family and Children’s Medicaid recertifications were auto-extended for 10 counties on the evening of January 19 th ^ Denotes Urban County COUNTY FNS Application Processing Timeliness (Processed Apps) As of COB 1/29 FNS Recertification Untimeliness Percentage (Pending Recerts) As of COB 2/3 Medicaid Application Untimeliness Percentage (Pending Apps) As of COB 2/3 Medicaid Recertification Outstanding Percentage (Pending Recerts) As of COB 2/3 Scotland*87%64%22%129% Wake*^81%82%52%124% Hoke83%62%21%98% Mecklenburg*^90%60%29%250% Harnett87%10%23%207% Pamlico73%10%26%111% Davie91%26%64%87% Forsyth*^92%50%52%72% Jones74%17%12%98% New Hanover*^92%44%5%113% Randolph*93%7%44%203% Rockingham76%45%14%69% Union85%72%14%95% Wayne90%66%7%218% Avery100%63%28%51% Burke82%2%11%111% Camden80%40%2%31% Cumberland^79%1%7%113% Durham^85%74%10%82% Iredell85%4%24%69% Madison93%75%12%51% Moore93%22%17%56% Pender89%30%6%92% Pitt95%2%25%99% Rowan92%20%19%66% Sampson89%8%3%120% Yancey84%36%7%46%

33. 33 Draft 33 NC FAST Schedule including Project 3

34. 34 Draft Acronyms AcronymDefinition ACAAffordable Care Act BCCBreast and Cervical Cancer Medicaid BSFBusiness System Function CACash Assistance CHIPChild Health Insurance Program EISEligibility Information System (legacy system) F&CFamily and Children’s Medicaid FFMFederally-Facilitated Marketplace FNSFood and Nutrition Services HSFState Foster Home Fund ITSOffice of Information Technology Services MAFMedical Assistance to Families with Dependent Children MAF-DFamily Planning Waiver MAGIModified Adjusted Gross Income MCHIPMedicaid Child Health Insurance Program MFCFoster Care MICMedicaid for Infants and Children MQB-QMedicaid Qualified Medicare Beneficiary MQB-BMedicaid Specified Low Income Medicare Beneficiary MQB-EMedicaid Qualifying Individuals 1(QI1) NCHCNorth Carolina Health Choice RARefugee Assistance SASpecial Assistance SDXState Data Exchange TANFTemporary Assistance to Needy Families USDAUnited States Department of Agriculture WF/WFFAWork First/Work First Family Assistance Draft 34