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Washington, DC Update 3/31/23
Legislative Updates
Long COVID Legislation
On March 15th, Senator Kaine (D-VA) and 10 Democratic co-sponsors, along with Representative Beyer (D-VA-8th) and Representative Bergman (D-MI-1st), introduced the Comprehensive Access to Resources and Education (CARE) for Long COVID Act ( S.801 / H.R.1616). This bill will work to improve the lives of those affected by Long COVID. Specifically, the bill will accelerate Long COVID research, improve the understanding of Long COVID treatment efficacy and disparities, educate Long COVID patients and medical providers through efforts at the Centers for Disease Control and Prevention (CDC) to develop and disseminate information on common symptoms and treatment for Long COVID and related conditions; facilitate interagency coordination to educate the public, including employers and schools, on the impact of Long COVID and the rights associated with employment, disability status, and education for individuals with Long COVID; and develop partnerships among community-based organizations, social service providers, and legal assistance providers to help individuals with Long COVID access needed services.
Unwinding of the Public Health Emergency & Medicaid Continuous Coverage
ACL: Unwinding focus for Aging and Disability Networks
Vicki Gottlich, Director of the ACL Center for Policy and Evaluation penned a blog that suggests 5 key things that the aging and disability networks need to know and share with their networks, and also provides links to a number of resources.


Blog: Unwinding and Children’s Mental Health
It is abundantly clear that policymakers across the nation need to step up to address the crisis in child and adolescent mental health and also ensure they are not taking actions that could worsen the crisis. One such step is working to ensure a smooth unwinding of Medicaid’s continuous coverage requirement that minimizes coverage disruptions and ensures children don’t lose access to needed mental health services. Read the blog by Georgetown Center for Children and Families that lays out just how.


National Association of Medicaid Directors (NAMD): Workforce Challenges and Unwinding 


Kaiser Family Foundation: How State Medicaid Programs Approaching the Unwinding of Medicaid Continuous Coverage


NAMD: Medicaid Agencies Look Toward a “New Normal” 

Check out this NAMD blog here which looks at some of the key factors states are taking into account as they try to accurately anticipate the future of their program.  
From the Administration
CDC: Reports on Autism
The CDC released two new reports from the Autism and Developmental Disabilities Monitoring (ADDM) Network  
  
Findings include new patterns in prevalence by race/ethnicity and a novel analysis showing dramatic impacts of COVID-19 on early evaluation and identification of autism.  

Key findings from these reports include:
  • The latest prevalence estimate of 1 in 36 8-year-old children is higher than the previous estimate published in December 2021 of 1 in 44 8-year-old children.  
  • For the first time, the percentage of 8-year-old Asian or Pacific Islander (3.3%), Hispanic (3.2%), and Black (2.9%) children identified with autism was higher than among 8-year-old White children (2.4%). This is the opposite of racial and ethnic differences observed in previous ADDM reports. These shifts may reflect improved screening, awareness, and access to services among historically underserved groups. 

The second report examined time of identification. While there have been improvements in early autism identification over time, the COVID-19 pandemic has disrupted progress. These disruptions in the timely evaluation of children and delays in connecting children to the services and support they need could have long-lasting effects.

NOTE: Through funding from PCORI, Family Voices is working with African American youth and families with and autism spectrum disorder (ASD) to increase engagement in ASD PCOR research by African Americans impacted by ASD and address the disparities in healthcare outcomes for African American children with ASD. Community Autism Research Ambassador Program - Family Voices


White House: Fact Sheets
On the 13th anniversary of the Affordable Care Act (ACA) becoming law, the White House released 51 state and territory fact sheets highlighting how extreme MAGA House Republicans’ plans to repeal the ACA and gut Medicaid will devastate working families. The fact sheets demonstrate how Congressional Republicans’ reported proposals will raise premiums and health care costs, threaten health care for Americans with pre-existing health conditions, slash protections against catastrophic medical bills, and will balloon waitlists for quality care for seniors and people with disabilities. You can find links to all the fact sheets here.


US DOT: SMART Grants Award
On March 21st, U.S. Transportation Secretary Pete Buttigieg announced the first round of grants totaling over $94 million for 59 projects across the country through the new Strengthening Mobility and Revolutionizing Transportation (SMART) Grants Program. The competitive grant program, established by President Biden’s historic Bipartisan Infrastructure Law, provides state, local, and tribal governments $500 million over five years to leverage technology to create safer, more equitable, efficient, and innovative transportation systems. Read the announcement. The full list of awards, including awards related to improving accessibility, totaling $94,783,781 can be viewed here


MACPAC: March 2023 Report to Congress 
MACPAC recently released their March 2023 report to Congress. The report includes a recommendation that HHS and CMS update the model streamlined application with new questions on race and ethnicity data and develop model training materials to ensure Medicaid applicants receive consistent information on the purpose of these questions. It also recommends that Congress allow Medicaid programs to mirror Medicare’s coverage with evidence development national coverage determination.
Other CYSHCN Policy-Related Materials of Interest
Survey Results: 50 States Medicaid and CHIP Eligibility and Enrollment
The Kaiser Family Foundation (KFF) and Georgetown University Center for Children and Families annual 50-State Survey on Medicaid and CHIP Eligibility and Enrollment was released 2 weeks ago. The survey focuses on state policies impacting children, pregnant individuals, parents, and other non-elderly adults whose Medicaid eligibility is based on financial eligibility rules. This year’s survey provides a snapshot of state actions at a watershed moment for Medicaid. The report is thorough and detailed, but also accessible with lots of highlights and takeaways.

Here are just a few:
  • States are adopting a range of approaches to unwinding the continuous enrollment provision, though most are taking as much time as possible to complete the process. 
  • The unprecedented volume of work ahead comes at a time when most states face significant staffing challenges.
  • A majority of states (43) have continued to process ex parte renewals over the past year and over half (30 states) have taken steps to increase the share of renewals completed via ex parte. Ex parte renewals reduce administrative burden

These highlights and much more can be found in this blog.


Blog: A History of Medicaid Managed Care
Ever wonder how, and when, Medicaid seemed to move to a managed care model? This Georgetown CCF blog provides an early legislative history that pinpoints a change in 1997, with the Balanced Budget Act.


NHeLP: Resources to Counter Medicaid Funding Cuts
Congressional Republicans are considering policies that would cut funding for Medicaid as part of the debt ceiling negotiation. Emerging proposals could include Medicaid block grants, per capita caps, and work requirements, which would limit federal funding and make it harder for people to access health care programs and services.

NHeLP’s team of legal and policy experts will analyze debt ceiling proposals as they emerge. They will continue to provide insights into the threats posed by block grants, per capita caps, and work requirements. If enacted, such policies would jeopardize the health and financial security of the tens of millions of low-income individuals and families who rely on Medicaid. This landing page has many resources such as fact sheets and blogs explaining, for example, the difference between per capita caps and block grants in Medicaid.

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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.