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Washington, DC Update 2/22/23
Legislative Updates
The House and Senate are out of session until February 23, 2023.
Healthcare Workforce Shortage
Prior to the President’s Day recess, the Senate HELP committee held its first hearing of the year about the healthcare workforce shortage. Senators listened to a panel that talked about needs, as well as strategies to expand the workforce like forgiving student loan debt, expediting healthcare workforce visas, expanding scholarships and other educational benefits, increasing reimbursement rates, and promoting a more diverse workforce. Addressing this issue appears to be a focus for the committee and has bipartisan support.
Here are some articles on the hearing and laying out the shortage issues:
HELP remarks and hearings

Unwinding of PHE & Medicaid Continuous Coverage
NHeLP: Protecting People with Disabilities and People with Limited English Proficiency during the Unwinding
State planning for the unwinding of the Medicaid continuous coverage provision needs to include evaluation of a state’s processes, policies, and systems for disability and language access. Failing to plan and monitor for disability and language access is the very type of disregard the non-discrimination protections were intended to prevent. This Issue Brief discusses the problem and poses questions advocates can ask of states to learn about the state’s planning for language and disability access.

Manatt webinar & materials: Breaking down guidance for states
On February 8, State Health and Value Strategies hosted a webinar during which experts from Manatt Health reviewed CMS’ recently released State Health Official (SHO) letter related to “unwinding” the Medicaid continuous coverage guarantee, based on provisions included in section 5131 of the Consolidated Appropriations Act, 2023 (CAA). Building on existing CMS guidance, the new SHO letter gives details about the requirements that states must meet to receive the enhanced federal medical assistance percentage; clarifies expectations for states to comply with the Medicaid, CHIP, and marketplace reporting elements required by the CAA; and reviews how the CAA will affect select COVID-19 public health emergency-related flexibilities and authorities.

The webinar reviewed the additional detail and operational expectations of states during the unwinding of Medicaid continuous coverage, as laid out in the SHO letter, and discussed key considerations for state policymakers.

Watch the webinar recording and access other materials here.

Charting all of the Unwinding
Georgetown Center for Children and Families: Unwinding Tracker
This tracker examines whether certain types of information can be found on a state's Medicaid or Marketplace website or in public documents: 1) the state’s unwinding plan or a summary; 2) an alert to update contact information; 3) communications materials/toolkits for partners; 4) an unwinding FAQ; and 5) whether the state plans to launch an unwinding data dashboard or publicly post key unwinding data.

To track your state with links to documents and webpages, click here.
See the Tracker Map here.

State Health Value Strategies and Manatt Health: Emergency Measures Chart
To help states respond to the ongoing COVID-19 pandemic, the White House, the U.S. Department of Health and Human Services, and the Centers for Medicare and Medicaid Services have invoked their emergency powers to authorize temporary flexibilities in Medicaid and the Children’s Health Insurance Program. Congress’s legislative relief packages have provided additional federal support for state Medicaid programs, subject to certain conditions. The timeframes for these emergency measures are shown in this chart, including the effective dates and expiration timelines.
Here is a comprehensive list of Public Health Emergency (PHE) and continuous coverage unwinding guidance and resources for advocates. Resources have been compiled from the Centers for Medicare & Medicaid Services (CMS), other federal agencies, and advocacy organizations, including the National Health Law Program. [Compiled and updated February 21, 2023 by the National Health Law Program (NHeLP)]

This recorded NHeLP webinar gives advocates red flags to watch for as states begin their unwinding period for the Medicaid continuous coverage provision. It reviews the minimum requirements for redeterminations and the different methods CMS is allowing states to use during the unwinding. NHeLP also discusses predicted problem areas and advocacy opportunities.

Find a PDF copy of the PowerPoint presentation here and a Q&A document based on questions asked during the webinar here.
From the Administration
White House: Celebrating Black Disabled Leaders for Black History Month
During Black History Month, the White House and the Biden Harris Administration are celebrating the contributions of Black disabled leaders to American history. The Administration will host a roundtable with the next generation of Black disabled young leaders and highlight Administration actions to promote equity.
Black History Month Roundtable with Young Black Leaders with Disabilities
February 23 | 10:30 AM ET
ASL and CART will be provided. 

HHS: Proposed Rule Kinship Care
The U.S. Department of Health and Human Services (HHS), through the Administration for Children and Families (ACF), announced a new proposed regulation to lessen obstacles in licensing standards for kinship foster caregivers. This proposed rule aligns with President Biden’s priorities on providing necessary resources to keep families together and support kinship care.
Currently, all foster family homes must meet the same licensing standards, regardless of whether the foster family home is a kin or non-kin placement. This updated regulation allows a child welfare agency to adopt different licensing standards for all kin foster family homes to lessen delays in the kinship foster family licensing process. Kin can include individuals related to a child by blood, marriage, or adoption and other individuals who have an emotionally significant relationship with the child, such as godparents and close family friends.

ACF’s Children’s Bureau encourages child welfare agencies to strongly consider developing standards for kin foster family homes that meet only the federal requirements and not additional standards the state, local, or tribal agency may require non-relative foster family homes to meet. These standards may include extending the age limits for kinship foster care providers, to allow for older kin to foster a child, or allowing kin children to share sleeping spaces. Read the full announcement here.

CMS: Improving Data to Advance Health Equity Solutions
The Centers for Medicare & Medicaid Services Office of Minority Health (CMS OMH) is hosting a webinar in recognition of its recently released white paper, The Path Forward: Improving Data to Advance Health Equity Solutions, on Tuesday, March 7 from 12:00 – 1:00 p.m. ET. Learn about the current state of health equity data collection, including progress to date and the actions that are being taken to improve health equity data collection across CMS and beyond.

The Path Forward: Improving Data to Advance Health Equity Solutions Webinar

March 7 | 12:00 PM ET

To learn more about CMS OMH’s research efforts and data sets, visit their Research and Data webpage or contact [email protected].

SSA: Plain Language
Recently, the Social Security Administration achieved the highest score of any agency in government on the Center for Plain Language’s 2022 Federal Plain Language Report Card.

The Center evaluated 21 Executive Branch agencies, including all 15 cabinet-level departments, and graded each between an A+ and F- for writing quality and organizational compliance. For more information, read the blog here.
You can access the full report card and many other materials about Plain Language from the Center for Plain Language here.
Other Policy related Materials of Interest
Reason Foundation: State Policy Agenda for Telehealth Innovation
States rapidly adopted telehealth technology under the COVID-19 public health emergency (PHE) regulatory flexibilities. Most emergency actions taken during the pandemic are temporary. However, states show a lack of urgency in making comprehensive updates to their telehealth laws in preparation for the end of the PHE. Pioneer Institute, Cicero Institute, and Reason Foundation released a report, which rates all 50 states in four critical areas of telehealth policy and provides recommendations on what each state needs to do to improve. For more information, see the Pioneer Institute's press release

Community Catalyst: Advocacy and Equity at the Center of Health Innovation Virtual panel discussion
This discussion features Center for Medicare and Medicaid Innovation (CMMI) Director Elizabeth Fowler, Ph.D., J.D. as well as artist, advocate, community organizer and fourth-annual winner of Community Catalyst’s Center for Community Engagement in Health Innovation Speak Up for Better Health Award winner – Sarah Schwegel. Community Catalyst will curate a timely and needed discussion on health innovation, equitable program and policy design, and the role of advocacy in shaping health care that is designed by people, for people.

February 24 | 2:30 PM ET
Transformational Community Engagement to Advance Health Equity
Within government, policy and programmatic changes are often made without engaging the people the changes will affect or the people currently experiencing the challenges of existing policies and programs. Inequities in COVID-19 mortality, morbidity, and vaccine distribution have shown the historical legacies and contemporary realities of distrust of government and the failures of our health and social services systems to meet the needs of people of color.

Community engagement is one of the ways states are attempting to establish and maintain trust and improve the accessibility and quality of services. This issue brief by State Health and Value Strategies outlines the ways community engagement can improve communication, lead to more effective and efficient programs, and result in ongoing collaboration with people who have experienced state-run systems and services.

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Family Voices is a national organization and grassroots network of families and friends of children and youth with special health care needs and disabilities that promotes partnership with families--including those of cultural, linguistic and geographic diversity--in order to improve healthcare services and policies for children.