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Washington, DC Update 11/10/22
Legislative Updates
Congress will return to Washington, D.C. next Monday, November 14, 2022.
From the Administration
Disability Advocate and artist Lois Curtis passed away last week at the age of 55. Many knew Lois as “L.C.” in the landmark Olmstead v. L.C. Supreme Court decision that recognized the right of people with disabilities to live in their own homes and receive services in their own communities. Rest in Power, Lois!

ACL: Grandfamilies & Kinship Support Network Seeking Exemplars
One of the goals of the Grandfamilies & Kinship Support Network, a National Technical Assistance Center (Network) funded by the Administration for Community Living (ACL), is to demonstrate measurable increases in the number of identified exemplary kinship/grandfamilies policies, practices, and programs implemented by state, tribal, and territorial agencies, and community-based organizations. The Network is identifying and designating exemplary kinship and grandfamilies policies, practices, and programs, with the goal of sharing replicable strategies with others.
The Network encourages applications from government agencies in states, tribes, and territories, as well as kinship navigator programs and other community-based organizations that serve kinship and grandfamilies. The designation of “exemplary” includes policies, practices, and programs that are evidence-based or evidence-informed, but such evidence is not required to be considered exemplary by the Network. We welcome the submission of policies, practices, and programs that have anecdotal or empirical evidence as well as those with characteristics associated with effectiveness. These can include policies, practices, and programs that have a long tenure, consistently high rates of participation, or those that are passed down over generations.  

CMS: 12-month Medicaid and CHIP Coverage after Pregnancy
The Center for Medicare and Medicaid Services announced that more than half of all states have expanded access to 12 months of Medicaid and Children’s Health Insurance Program (CHIP) coverage after pregnancy. Georgia and Pennsylvania are the 25th and 26th states to be approved for the extended coverage, made possible by provisions in the American Rescue Plan (ARP), signed into law by President Biden in March of 2021.
State Policies of Interest to CYSHCN
Rhode Island: Wage Increase for Direct Care Workers
The Center's long-time partner Rhode Island Organizing Project (RIOP) has achieved many incredible successes over the years as they have worked with low-income elders and adults with disabilities to improve access to health care, transportation and community-based services. Their latest victory is around wages for the direct care workers who provide services and supports for seniors and adults with disabilities. Through the Voices for Better Health partnership with The Economic Progress Institute and Senior Agenda Coalition of Rhode Island, RIOP worked with SEIU and others to secure increased wages for direct support workers. Workers hired by individuals through the Independent Provider and Personal Choice programs will now be paid a minimum of $15/hour.

Arkansas: Waiver for Health-Related Social Needs
The U.S. Department of Health and Human Services (HHS), through the Centers for Medicare & Medicaid Services (CMS), approved an amendment to Arkansas' Medicaid section 1115 demonstration that will test innovative interventions to address housing and food insecurity, as well as other critical health-related social needs. Like recently approved section 1115 demonstration initiatives in ArizonaMassachusetts, and Oregon, the amendment to the Arkansas Health and Opportunity for Me (ARHOME) demonstration will drive better health and wellbeing outcomes for beneficiaries in crisis by providing medically necessary support services, particularly for young people, pregnant and postpartum women, and those dealing with mental illness and substance use diagnoses.

The approved amendment will address various health-related social needs among targeted populations through coverage of intensive care coordination and other person-centered supports provided by "Life360 HOMEs." Life360 HOMEs are designed to connect people to necessary health services and community supports while actively engaging participants in promoting their own health.

The state will work with local hospitals and community partners to advance three types of Life360 HOMEs:
  • Rural Life360 HOMEs will support individuals with serious mental illness and/or substance use diagnoses who live in rural areas;
  • Maternal Life360 HOMEs will support individuals with high-risk pregnancies up to two years postpartum; and
  • Success Life360 HOMEs will support young adults (ages 19-24) at high-risk for long-term poverty and poor health outcomes due to prior incarceration, involvement with the foster care system, or involvement with the juvenile justice system, as well as veterans ages 19-30 who are at high risk for homelessness.

For additional information about the ARHOME section 1115 demonstration, consider reading this HHS press release or visit Medicaid.gov.
Other Policy-Related Materials of Interest
Blog: New and Improved ACA Navigator Guide
November 1st started the tenth open enrollment period for the ACA marketplace. The Georgetown Center on Health Insurance Reforms has updated a new guide, with funding from the Robert Wood Johnson Foundation, that contains over 300 Frequently Asked Questions (FAQs) as well as additional features, such as:
  • What’s New for 2023,” a page outlining new policies that will affect the marketplace in 2023, such as the Inflation Reduction Act;
  • Top FAQs translated into Spanish;
  • New and revised FAQs on the “family glitch,” abortion access, and new “easy pricing” plans on the federal marketplace;
  • Updated state fact sheets, which now include information on immigrant eligibility for health coverage;
  • Ask an Expert” option for Navigators and assisters to submit questions about the Affordable Care Act and the marketplaces, and continued highlights of resources for diverse communities; and
  • State fact sheets that provide state-specific information on both private insurance and Medicaid/Children’s Health Insurance Program (CHIP) coverage.

Explore the updated Navigator Resource Guide here.

More Open Enrollment: Toolkit from Young Invincibles
Young Invincibles has created an Open Enrollment 10 Partner Toolkit. The toolkit includes resources such as key messaging, updates that will impact enrollment, the weeks of action calendar, and social media content to make posting easier. It is available in English and Spanish and includes social media messaging.

Child Trends: Federal Policies that Contribute to Racial and Ethnic Inequities for Indigenous Children and Families
In response to a request for input from the National Academies of Sciences, Engineering, and Medicine’s Ad Hoc Committee on Racial and Ethnic Health Inequities, Dr. Heather Sauyaq Jean Gordon, Dr. Deana Around Him, and Elizabeth Jordan of Child Trends provided examples of federal policies that contribute to racial and ethnic health inequities for Indigenous children, families, and communities. Their comments also offered the following considerations for improving federal efforts that seek to advance Indigenous health: 
  • Respect for Indigenous sovereignty and self-determination is essential to Indigenous health and wellbeing. 
  • Overturning the Doctrine of Discovery and returning land to Indigenous Peoples is central to Indigenous health because relationships with the land are tied to wellbeing. 
  • Indigenous Peoples’ wants, needs, cultures, voices, perspectives, and knowledge must be meaningfully heard and included in policy changes and implementation.   
  • Due to colonization, Indigenous Peoples live on lands with extensive environmental injustices, and the federal government has a role in righting these injustices.   

NAMD: New Federal Policy Brief on Cross-Agency Collaboration
Medicaid and CHIP programs cover many behavioral health and physical health care services, core components of a patient’s treatment plan. However, there are many services that Medicaid programs typically cannot cover, including housing, legal supports, and education. This means that State Medicaid Agencies must form partnerships with other state, federal, and local agencies to create a seamless continuum of care. A new brief by the National Association of Medicaid Directors discusses how federal partners can support cross agency collaboration.

Medical Debt: Hispanic Families
Community Catalyst and the National Consumer Law Center recently hosted a bi-lingual webinar discussing the impact of the medical debt crisis on Hispanic families. Here are links to the English recording and fact sheet and the Spanish recording and fact sheet.

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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.