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Washington, DC Update 3/15/23
Legislative Updates
House lawmakers are out until March 22, and the Senate returns this week.
Following the release of the president’s fiscal year (FY) 2024 budget request late last week, several Biden Administration officials will be up on the Senate side testifying on the requests for their respective agencies.

The President’s Budget
The FY 2024 appropriations season is kicking into high gear following the release of President Biden's budget last week. The $6.9 billion request — which is unlikely to get any traction in the divided 118th Congress — includes a host of spending requests to support: (1) expanded support for childcare and prekindergarten; (2) Medicaid expansion; (3) renewing the expired Child Tax Credit (CTC); and (4) national paid family leave, among others. The president's budget also outlined a series of tax increases on wealthier individuals and corporations to help fund these initiatives, including making some of the 2017 tax cuts under the Tax Cuts and Jobs Act (TCJA) permanent for taxpayers making under $400,000 per year. Biden Administration officials begin testifying this week on the requests of their respective agencies. Meanwhile, House Budget Committee Chair Jodey Arrington (R-TX) stated that the GOP's budget proposal would take "at least" 30 days to finish and that there is no timeline for its release at the moment.

If you would like to read the President’s proposed budget, tables, history and specific analysis, you can find it here. You can also read a summary here: White House Budget Fact Sheet

Georgetown CCF Say Ahhh! Blog has a piece briefly looking at the provisions related to Medicaid and CHIP in the President’s budget.

QALY Legislation Hearing
House Energy and Commerce Committee Chair Cathy McMorris Rodgers (R-WA) and Health Subcommittee Ranking Member Anna Eshoo (D-CA) are closing in on a bipartisan agreement on legislation that would ban the Quality Adjusted Life Years (QALY) after the Protecting Health Care for All Patients Act of 2023 (H.R. 485) passed the subcommittee with strong bipartisan support last Wednesday. The bill would prohibit all federal health care programs from using prices based on the measure to determine coverage or reimbursement thresholds. It will now head to the full committee for a markup at a date and time to be announced.

For more on QALYs, consider reading this National Council on Disability report.

HCBS Legislation
On Thursday, March 9, U.S. Senate Special Committee on Aging Chairman Bob Casey (D-PA) held a hearing entitled “Uplifting Families, Workers, and Older Adults: Supporting Communities of Care,” which examined the economic benefit of investing in Medicaid home and community-based services (HCBS). Investing in home care would address the decades-long workforce shortage crisis, creating jobs and allowing family caregivers to return to their careers if they wish. It would also help raise wages and improve benefits for caregivers, which would boost economic activity and consumer spending.

Chairman Casey also introduced a new bill, the HCBS Access Act, which would, over time, eliminate the lengthy waiting lists for home care services. The HCBS Access Act would put home care on equal footing with long-term care facilities under Medicaid, ensuring eligible older adults and people with disabilities have a real choice of care and support options. U.S. Representative Debbie Dingell (D-MI-6) introduced companion legislation in the House.
Unwinding of Medicaid Continuous Coverage
The Long Unwinding Road: States Prepare for the End of the Medicaid Continuous Coverage Requirement This article is a great reference in digestible language. It is broken up into sections that you can scroll to read if you are just looking for better understanding and links about a specific aspect of Medicaid unwinding, such as: state strategies for prioritizing redeterminations, leveraging partnerships with MCOs, unwinding dashboards, strengthening workforce and simplifying coverage transitions. Links to materials, including specific state plans, are found throughout.

Georgetown CCF Blog: Dates for Action!
Recently CMS posted dates that states are initiating action as we quickly approach the unwinding of Medicaid continuous coverage. So, what do these dates mean at the operational level? Access the Say Ahhh! blog to find answers.

CMS: Messaging and Outreach Resources
State Medicaid agencies are beginning to unwind the Medicaid and CHIP continuous coverage provisions enacted in early 2020 to adapt to the COVID-19 pandemic. With some states beginning terminations of coverage as soon as April 1, 2023, advocates have an important role to play in messaging and outreach to prepare enrollees to renew their coverage. This document contains a comprehensive list of messaging and outreach resources for advocates related to the Medicaid and CHIP continuous coverage unwinding. Resources have been compiled from the Centers for Medicare & Medicaid Services (CMS) and advocacy organizations. Download the publication here.

During the Medicaid continuous coverage unwinding, automatic or “ex parte” renewals will be critical to keeping people enrolled. States are required to attempt the ex parte process for all Medicaid enrollees, including non-MAGI enrollees with asset tests. But states report continued problems completing ex parte renewals for these individuals, disproportionately impacting Medicaid enrollees who are age 65 or older, blind, or disabled. Download the National Health Law Program publication here.

SVHS: Social Press Kit
This link from the State Value and Health Strategies Center, found on their Unwinding Resource page, includes suggested messaging for texts, templates and other messaging suggestions or states to use with regard to the unwinding of Medicaid continuous coverage. The items to download include specific templates as well as suggested messaging for CYSHCN that may be of interest for F2F/AOs so you can be aware of guidance your state Medicaid is receiving about messaging.
Unwinding of PHE
CMS: Guidance for the End of the COVID-19 Public Health Emergency on May 11
CMS is preparing the public for the transition forward from the COVID-19 public health emergency (PHE) and has outlined what to expect after this period ends. In a new fact sheet, CMS discusses COVID-19 testing, vaccines and treatments; telehealth services; continuing flexibilities for health care providers and inpatient hospital care at home. The Biden-Harris Administration and CMS will continue to provide guidance to the public to ensure a smooth and predictable transition as May 11 approaches.

Center for Connected Health Policy: Telehealth and Unwinding of PHE
As the May 11, 2023 end date of the public health emergency (PHE) draws near, recent actions and releases by both Congress and federal agencies paint a clearer picture of what the post-PHE federal telehealth policy landscape will look like. In December 2022, with the passage of the Consolidated Appropriations Act of 2023 (2023 CAA), several major federal telehealth policy questions were addressed. Temporary telehealth policies in Medicare such as a waiver of the geographic requirement were extended to December 31, 2024 (read CCHP’s write up on preparing for the end of the PHE)However, Centers for Medicare and Medicaid Services (CMS) and the Drug Enforcement Administration (DEA) recently released several fact sheets or proposed rules that address other temporary telehealth policies that were not touched upon by the 2023 CAA.

CMS released a series of provider-specific fact sheets as well as an Overview Fact Sheet that addresses what will happen to specific temporary PHE waivers after May 11, 2023. Among the items discussed were telehealth-specific waivers. Some of the issues noted were not only ones included in the 2023 CAA or previous actions taken through the regulatory process, but also waivers made during the PHE, the fates of which in a post-PHE environment were unknown until now. For example, during the PHE providers are able to provide telehealth delivered services from their homes without reporting their home address. This waiver will continue through December 31, 2023, at which time policy will likely revert back to pre-COVID policy which requires providers to report to CMS the address of where they are when delivering services via telehealth, even if it is their home address.
From the Administration
White House: Young Black Leaders with Disabilities Roundtable
On Feb. 23, 2023, the White House hosted a Black History Month roundtable. The purpose of the event was to not only reiterate the Biden-Harris Administration’s commitment to diversity, equity, accessibility and disability inclusion, but to also hear from young Black leaders about their experiences and challenges." 
Watch the recording of the roundtable here.

CMS: Connecting Kids to Coverage Campaign - Focus on Dental
Every February the Connecting Kids to Coverage National Campaign observes National Children’s Dental Health Month. Because oral health is important year-round, the Campaign is taking the opportunity again this month to shine a light on dental health to help ensure a child’s overall health.

The Campaign is excited to share new resources geared toward improving oral health that will help partners and grantees reach more families in their communities and encourage them to enroll in Medicaid and CHIP to access important dental services. You can find these new items and more on InsureKidsNow.gov and the Oral Health Initiative page.
  • Dental Health Coloring Pages – These ready-to-print coloring pages can be shared with families in your community and are a great way to engage children while also reminding parents and caregivers about the importance of oral health care. The coloring pages are currently available in English and Spanish.
  • “Think Teeth” Materials in New Languages – Our “Think Teeth” dental health poster, flyer, and tear pads are now available in 24 languages including English, Spanish, Amharic, Armenian, Arabic, Burmese, Chinese, French, Farsi, German, Greek, Haitian Creole, Hmong, Italian, Korean, Khmer, Lingala, Marshallese, Polish, Portuguese, Russian, Somali, Tagalog, and Vietnamese.

For additional materials, including social media graphics, videos, email signatures, newsletter templates, text messages, and videos that cover a wide range of CKC initiatives, please visit the Outreach Tool Library.

the National Association of Councils on Developmental Disabilities (NACDD) and its partners collaborate to lead Developmental Disabilities Awareness Month (DDAM). 

The campaign highlights how people with and without disabilities come together to form strong communities. DDAM raises awareness of the inclusion and contributions of people with developmental disabilities in all aspects of community life, and it's a time to explore the work we still need to do to remove barriers.

The 2023 theme, Beyond the Conversation, focuses on the question, "what next?"
ACL link to DDAM communication tools, news, and other materials.
Other CYSHCN Policy-Related Materials of Interest
Black Feathers Live Podcast: DD Awareness Month
In celebration of Developmental Disabilities Awareness Month, the Black Feathers Podcast will be putting on a live show in collaboration with the National Association of Councils on Developmental Disabilities (NACDD) on Tuesday March 21, 2023 3:00-4:30 pm EST.
The Black Feathers Podcast is a product of The State of the States in Intellectual and Developmental Disabilities Project of National Significance funded through ACL and produced in collaboration with the Kansas University Center on Developmental Disabilities (KUCDD). Podcast episodes are posted on the Black Feathers Podcast website.
Special guests include Sarah Young Bear-Brown from the Sac and Fox Tribe of the Mississippi in Iowa, Cheryl and Kody Funmaker of the Ho-Chunk Nation in Wisconsin, and Darold H. Joseph of Paa-Is-wung-wa (Water Coyote Clan) from the Hopi Village of Lower Moenkopi.

Register to join the live taping of the podcast here.

Webinar Series: Center for Youth Voice, Youth Choice
The Supporting Youth and Young Adults with Intellectual and/or Developmental Disabilities (IDD) with Decision-Making: What Every Parent Needs to Know is intended for parents of youth and young adults with IDD who are interested in gathering information about the range of options for providing decision-making support. The series will review the facts and myths about these options, discuss ways to maximize youth decision-making and self-determination, and emphasize strategies and action steps for parents and youth. The webinars will be offered over Zoom and will be recorded. All sessions will be held from 3:00-4:00pm Eastern Time.
Future webinars will cover topics that include preparing for when your child turns 18, taking a closer look at supported decision-making, and supporting healthcare-related decision-making. Featured speakers will include content experts from the Center on Youth Voice, Youth Choice (CYVYC), as well as youth with intellectual or developmental disabilities (IDD) and their parents!

Kick-Off Webinar March 27, 2023 3-4 pm EST
Register here
Access the flyer for sharing here

Featured Speakers
  • Allison Hall, Director of the Center on Youth Voice, Youth Choice
  • Morgan Whitlatch, Director of Supported Decision-Making Initiatives, Center for Public Representation
  • Jane St. John, parent and lead developer of Charting the LifeCourse Framework, University of Missouri, Kansas City –  Institute for Human Development
  • Derek Heard, Georgia Youth Ambassador, and Teresa Heard, Derek’s mother and supporter.

FOR MORE INFORMATION: Jaimie Timmons, Jaimie.timmons@umb.edu

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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.