Washington, DC Update 1/30/23 |
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Committee assignments will be finalized this week. Here are the links for the committees of jurisdiction for the F2F program:
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The Chair of the Energy and Commerce Committee is Representative Cathy McMorris Rogers (R-WA-5) and the Ranking Member is Representative Frank Pallone (D-NJ-6).
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The Chair of Senate Finance Committee is Senator Wyden (D-OR) and the ranking member is Senator Crapo (R-ID).
The Debt Ceiling and Children’s Health
While Congress is still working on committee assignments, rules and getting all of its leaders in place as the 118th Congress slowly begins its work, the debt ceiling is already a topic of conversation. How can this be if the last Congress just passed a spending bill? Why are we talking about funding already and how does that affect important programs related to CYSHCN such as Medicaid, CHIP and SSI? Consider watching this very short 1.5 minute video by Community Catalyst for a simple explanation of the issue and its implications.
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Unwinding of the Public Health Emergency |
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Created by the National Health Law Program, this comprehensive list of Public Health Emergency (PHE) and continuous coverage unwinding guidance and resources is available for download. Resources have been compiled from the Centers for Medicare & Medicaid Services (CMS), other federal agencies, and advocacy organizations, including the National Health Law Program. Download the publication here.
The list of resources is long, so consider saving in a resource folder for the PHE and looking through the headings to see which topics meet your information needs.
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CDC: Annual Report
The Center for Disease Control and Prevention’s National Center on Birth Defects and Developmental Disabilities (NCBDDD) has released their annual report for Fiscal Year 2022. NCBDDD has continued to work to provide data and protect the health of people with disabilities throughout the COVID-19 pandemic and the outbreak of monkeypox cases last year. NCBDDD has also worked to identify and address systematic barriers to health equity. Read the report for more on the work that NCBDDD has done over the past year.
White House: Human Trafficking and Disability
President Biden has proclaimed January National Human Trafficking Prevention Month. On December 30, the Administration for Children & Families published this blog by Katherine Chon, founding director of the Office on Trafficking in Persons, in recognition of the International Day of Persons with Disabilities. According to the National Disability Rights Network, people with disabilities are more likely to experience human trafficking than their peers. The blog describes important strategies to center accessibility when serving people with disabilities and provides links to multiple resources.
CMS: Summary of Access to Medicaid/CHIP Coverage and Care
CMS released Request for Information (RFI): Access to Coverage and Care in Medicaid & CHIP (referred to as 2022 Access RFI) with a public comment period from February 17, 2022, through April 18, 2022. The 2022 RFI was structured around five objectives and framed across three dimensions of health care access: (1) enrolling in coverage, (2) maintaining coverage, and (3) accessing services and supports.
The report takes the following steps to summarize the findings and key themes:
- Breaks down top themes observed in public comments by respondent type
- Summarize public comment themes by RFI objective or priority topic (for example, HCBS)
- Identifies findings and key takeaways across objectives
The most common themes were related to the following areas:
- Addressing equity and cultural competence, including suggestions to collect and analyze outcomes by sociodemographic data, to establish minimum standards that take cultural competence and language preferences into account, and to improve provider cultural competence
- Reimbursement rates as a key driver of provider participation in Medicaid and CHIP programs
- Aligning approaches and setting minimum standards for payment regulations and compliance across Medicaid and CHIP delivery systems, services, and benefits to ensure beneficiaries’ access to services is as similar as possible across beneficiary groups, delivery systems, and programs
Find the full report here.
HHS: Youth Mental Health
The U.S. Department of Health and Human Services (HHS) has awarded nearly $245 million in Bipartisan Safer Communities Act funding – $185.7 million from the Substance Abuse and Mental Health Services Administration (SAMHSA) and nearly $60 million from the Health Resources and Services Administration (HRSA) – to support youth mental health, help the health care workforce address mental health needs, and fund other critical mental health supports.
SAMHSA’s Bipartisan Safer Communities Act awards include:
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$73.6 million for Project Advancing Wellness and Resiliency in Education (Project AWARE) to help develop and support school-based mental health programs and services;
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$57.7 million in Mental Health Awareness Training grants to prepare and train school personnel, emergency first responders, law enforcement and others to recognize the signs and symptoms of mental health challenges to enable early intervention;
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$14.9 million for School Based Trauma-Informed Support Services and Mental Health Care for Children and Youth to increase student access to evidence-based and culturally relevant trauma support services and mental health care;
- $19.5 million for the National Child Traumatic Stress Initiative, to improve treatment and services for children, adolescents, and families who have experienced traumatic events; and,
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$20 million in Resiliency in Communities after Stress and Trauma grants to promote resilience and equity and prevent violence in communities that have recently faced civil unrest, community violence, and/or collective trauma.
HRSA’s Bipartisan Safer Communities Act awards include:
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Nearly $60 million to support the integration of mental health training into the training of primary care clinicians, with a specific focus on preparing primary care providers to treat the mental health needs of children and adolescents.
HHS: Administration for Children, Youth and Families
Health and Human Services (HHS) Secretary Xavier Becerra formally swore in Rebecca Jones Gaston as commissioner of the Administration on Children, Youth and Families (ACYF) at the Administration for Children and Families (ACF) within HHS. Prior to her role at ACYF, Commissioner Jones Gaston led human services agencies in two different states and worked as a social worker, advocate, therapist, and consultant. ACF is a division of HHS that is charged with working to promote the economic and social well-being of children and families. Consider taking a few minutes to check out their website. Scroll down and follow links to the issues they address and strategic plan. ACF also provides grant funding; consider ways for F2Fs to partner with other state and community organizations to promote well-being of the whole child and family.
DOL: Disability Employment Disparities
The U.S. Department of Labor’s Office of Disability Employment Policy releases employment labor force statistics, which show the employment rates for people with disabilities versus people without disabilities. In December 2022, working-aged (16-64) people with disabilities had a labor force participation rate of 39% and an unemployment rate of 5.4%. For people without disabilities, the labor force participation rate was 76.9% and the unemployment rate was 3.2%.
White House: Initiative on Asian Americans, Native Hawaiians and Pacific Islanders
At a special virtual event, senior Biden-Harris Administration officials outlined the details of 32 federal agency plans, which build on the Administration’s previous actions to promote safety and equity for AA and NHPIs. Community leaders also discussed additional steps the federal government can take to address critical priorities for AA and NHPI communities, including data disaggregation, language access, and combatting anti-Asian hate. Watch the full event here. WHIAANHPI is also soliciting public feedback on the agency plans here.
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State Policies of Interest to CYSHCN |
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HHS: Washington ACA 1332 waiver removes immigration requirements
U.S. Department of Health and Human Services (HHS) and the U.S. Department of Treasury approved Washington’s State Innovation Waiver under Section 1332 of the Affordable Care Act (ACA). This section 1332 waiver authorizes Washington’s state exchange to expand access to health and dental plans for state residents across all incomes, regardless of their immigration status, beginning January 1, 2024. When the ACA was passed, it excluded undocumented immigrants, including DACA recipients, from enrolling in marketplace plans. This waiver effectively removes the immigration requirements to enroll in exchange plans for Washington residents. Read more about Washington’s new waiver HERE.
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Other CYSHCN Policy Related Materials |
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CCF Blog: Community Health Workers
Among the health provisions in the Consolidated Appropriations Act of 2023, the law strengthened language and authorized $50 million annually for fiscal years 2023 through 2027 for community health workers (CHWs).
The new law shifts the language of the Public Health Service Act toward recruiting, hiring, training, and retaining a CHW workforce that reflects the needs of communities. Section 2222 of the law directs the HHS Secretary to award grants, contracts, and cooperative agreements to “promote positive health behaviors and outcomes for populations in medically underserved communities by leveraging community health workers, including by addressing ongoing and longer-term community health needs, and by building the capacity of the community health worker workforce.” The law directs this future funding towards community health workers who provide education and outreach to medically underserved communities and other at-risk populations, including people living in geographic areas that may require additional support during future public health emergencies.
A recent example of pediatric CHW funding is Washington state’s Medicaid program, which received state funding to pilot using CHWs in pediatric primary care settings. Their request for matching federal funds is currently under review.
Washington’s pilot offers a way to learn how states can engage CHWs to provide preventive services as part of pediatric primary care teams or home visiting teams with Medicaid funds. CHWs can also help states more effectively support underserved communities through relationships with trusted community members who understand their communities’ unique experiences and cultures, with the potential to live up to the goal of child- and family-centered care. Read the full blog by Georgetown Center for Children and Families HERE.
NHELP Blog: Medicaid Managed Care Accountability
This NHELP blog provides a breakdown and overview of an analysis of managed care contracts to identify different categories of sanctions and the reasons the states may impose them. The blog explores examples of sanctions, as well as reporting requirements.
Accountability for managed care organizations (MCOs) is critical for CYSHCN because, in the Medicaid program, comprehensive managed care is the predominant mode for delivering services. Approximately, seventy-two percent of beneficiaries receive services through managed care, covering 57 million people, in forty-one states. The contracts between MCOs and state Medicaid agencies spell out the services and benefits MCOs must provide Medicaid beneficiaries. Contracts also include penalties that states may impose if the MCOs fail to meet contractual requirements, or fall short in other ways, such as if the services provided are of poor quality and do not meet performance standards and benchmarks. These penalties often take the form of sanctions.
NCD Report: Supreme Court Decision Analysis and Implications
The National Council on Disability recently published Cummings v. Premier Rehab Keller PLLC: Implications and Avenues for Reform, a report that examines the U.S. Supreme Court decision of April 28, 2022. In that case, justices held that a plaintiff bringing suit to enforce the antidiscrimination provisions of Section 504 of the Rehabilitation Act of 1973 or Section 1557 of the Patient Protection and Affordable Care Act cannot recover damages for emotional distress resulting from intentional disability-based discrimination.
The Cummings decision eliminated the ability of people who experience disability-based intentional discrimination to obtain emotional distress damages from public and private entities who receive federal financial assistance from the Federal Government under Section 504 of the Rehabilitation Act of 1973 or Section 1557 of the Patient Protection and Affordable Care Act. As a result of the decision, entities such as public and private colleges and universities, hospitals, group homes, physical therapist offices, and others who receive federal financial assistance, including federal grants, loans, or other forms of federal financial assistance will no longer need to remedy discrimination based on disability when the only harm of the discrimination results in anxiety, stress, depression, marital strain, humiliation, or other similar emotional pain.
NCD also reviewed state human and civil rights laws to determine if they had (1) a public accommodation section, and, if so, (2) whether disability was a protected class, and (3) whether emotional distress damages are allowed for prevailing complainants in administrative actions or plaintiffs in a civil action. That analysis is included as an appendix. NCD concludes the brief with recommendations for legislation and administrative action.
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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.
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