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Washington, DC Update 9/23/22
Legislative Updates
Both chambers are back in session this week, and there are just 3 weeks left to avoid a government shutdown. A temporary spending bill to keep the government funded until mid-December is still expected this week.
Mental Health
Early reports show that many people are using the new 988 hotline for mental health, with 360,000 people calling the line and 100,000 texting or chatting since it began in July. You might already know that Senator Bennet (D-CO) and Cornyn (R-TX) teamed up to write an issue brief on “re-imagining mental health care.” This week, Senator Bennet sent a letter to the Biden administration urging that CMS update guidance on Medicaid funding for school-based mental health care. So far, the only bill introduced is the bi-partisan Mental Health Reform Reauthorization Act of 2022 sponsored by Senators Murphy (D- CT), Tina Smith (D-MN), and Cassidy (R-LA) in May. It has been referred to the Senate HELP Committee. As we come off the August recess, it looks like a mental health bill is still a possibility before the end of the year.
From the Administration
Hispanic Heritage Month: Materials for Access
In honor of Hispanic Heritage Month, the CMS Office of Minority Health will be focusing on the nation’s 60.5 million Hispanics by highlighting some common health disparities facing Hispanic populations and sharing resources focused on achieving health equity.

Like other minority groups, Hispanic populations are disproportionately affected by chronic health conditions, such as diabetes, cancer, and heart disease. Hispanic subpopulations also face their own distinct health disparities including higher rates of smoking among Puerto Rican and Cuban male populations, as well as higher rates of chronic liver disease and cirrhosis among Mexican populations. Hispanic populations have lower rates of health insurance coverage compared to their non-Hispanic counterparts, with nearly 30% of Hispanic adults aged 18 to 64 being uninsured. Additionally, among Hispanic pregnant individuals, the maternal mortality rate increased significantly from 2019 to 2020, largely due to COVID-19 related health disparities.

As Hispanic populations continue to face disparities related to COVID-19 and other health conditions, it is important to support culturally and linguistically responsive care from health care providers so patients are able to take steps towards better health. Below, please find materials in Spanish, data, resources on language access, culturally and linguistically appropriate services (CLAS), and more. Throughout this month and beyond, we encourage you to review and share these resources to continue to advance health equity.

A Practical Guide to Implementing the National CLAS Standards helps health care organizations implement the National CLAS Standards, improve health equity, and provide practical tools and examples of CLAS.

Guide To Developing a Language Access Plan is a resource to help organizations develop a plan to provide services to individuals who have limited English proficiency.

Improving Cultural Competency for Behavioral Health Professionals e-learning program for behavioral health professionals is intended to increase their cultural and linguistic competency.

MCHB Webinar: National Survey Children’s Health
MCHB Division of Research, as part of their Engaging Research Innovations and Challenges (EnRICH) webinar series, is hosting a webinar intended for a range of data users. Join the webinar to learn more about how you can use data from the National Survey of Children's Health (NSCH) to accomplish your goals for our children and youth with special health care needs.

Date: Tuesday, September 27, 2022 from 2:30 - 3:30 PM ET

Visit the registration link to read the problem statement and learning objectives. The newest NSCH dataset will be released on Child Health Day, October 3, 2022. 

ACL: No Wrong Door Grants Awarded in 10 States
ACL announced new grants to 10 states to establish and strengthen a No Wrong Door (NWD) governance structure within the state. The award recipients include Alaska, California, Indiana, Missouri, North Carolina, New Hampshire, Nevada, South Carolina, Tennessee, and Texas. Total grant awards amount to $3.9 million over two years.

The NWD vision includes national standards, tools, metrics, and best practices that all states can use to develop a single “high performing” access system to serve all populations who may need any long-term services and supports (LTSS), regardless of payer. With the adoption of a NWD vision, each state has a single, coordinated statewide system where multiple agencies at the state and local levels work together to create a simpler process for individuals and family caregivers to find unbiased information and one-on-one counseling on the options available in their communities. 

The new NWD governance grantees will focus on strengthening the NWD governing body in their state, assessing individual caregiver access, and mapping this access from the state and individual family caregiver perspective. Contact NoWrongDoor@acl.hhs.gov with questions about the No Wrong Door governance awards.

CMS: RFI Make Your Voice Heard
Today, the Centers for Medicare & Medicaid Services (CMS) released a Request for Information (RFI) seeking public input on accessing healthcare and related challenges, understanding provider experiences, advancing health equity, and assessing the impact of waivers and flexibilities provided in response to the COVID-19 Public Health Emergency.

The Make Your Voice Heard: Promoting Efficiency and Equity Within CMS Programs RFI supports CMS’s commitment to engaging and learning from partners, communities, and individuals across the health system to inform how they can better support the populations they serve. In alignment with Executive Order 13985, Advancing Racial Equity and Support for Underserved Communities Through the Federal Government, the CMS Strategic Plan Pillar: Health Equity and the CMS Framework for Health Equity (2022-2032), this RFI aims to gather perspectives about challenges and opportunities for the Agency to embed health equity into their efforts encouraging innovation, reducing burden, and creating efficiencies across the healthcare system.

CMS is seeking to better understand individual and community-level burdens, health-related social needs, and opportunities for improvement that can reduce disparities and promote efficiency and innovation across our programs. CMS is requesting information related to strategies that successfully address drivers of health inequities, including opportunities to address social determinants of health and challenges underserved communities face in accessing comprehensive, quality care. For example, challenges accessing care may include understanding coverage options, receiving culturally and linguistically appropriate care, accessing oral health services, and accessing comprehensive and timely healthcare services and medication.

The RFI is open for a 60-day public comment period beginning September 6, 2022. Comments must be received by November 4, 2022 to be considered.

The web-based public comment form was specifically designed to provide easy access and an improved user experience for submitting information. For more information on the Make Your Voice Heard: Promoting Efficiency and Equity Within CMS Programs RFI and to access the web-based public comment form, please visit: https://www.cms.gov/request-information-make-your-voice-heard

ACL: Assistive Technology Grant
ACL awarded a new grant to the Association of Assistive Technology Act Programs (ATAP) for the AT3 Center, Accessibility Training, Technical Assistance, AT Programs - AT3 Center. This award, which is authorized by the Assistive Technology Act of 2004 (AT Act), will fund activities to support public awareness and access to AT devices and services; state and national training and technical assistance; the development and maintenance of a national AT public internet site; and to enhance the effectiveness of state and territory AT Act programs.

The AT3 Center will use traditional and innovative approaches to assist State Grant for AT programs, individuals with disabilities across the lifespan, older adults, and stakeholders through information dissemination, and provide state-specific, regional and national training and technical assistance concerning state-level and state leadership activities conducted under the AT Act, including assistance with the development of advisory councils and a national AT public internet site to provide comprehensive, up-to-date information on resources related to programs that provide access to AT. The AT3 Center will also focus efforts on strategies that increase partnerships across AT programs, aging and disability networks, organizations, providers and professionals that regularly interact and serve people with disabilities, older adults, family members and caregivers. 

Reach out to the National Assistive Technology Act Technical Assistance and Training (AT3) Center, Contact us - AT3 Center, for more information about the new AT National Activities grant award. You can contact your state or territory AT Program directly at State/Territory AT Programs - AT3 Center for information and assistance to increase your awareness and access to AT devices and services where you live. 

ICYMI: Comments on Section 1557 of the ACA
The Biden Administration has proposed changes that would strengthen Sec. 1557 protections and is accepting public comments through October 3, 2022.
The National Health Law Program has written several materials to help understand how the proposed rule changes will affect certain groups who face discrimination in the health care setting. NOTE: There are several more blogs highlighting certain groups coming soon- including for those with disabilities!
Collection of Policy Related Materials
NASHP Publication: Partnerships between State Leaders and CHW
Some F2Fs are certified as community health workers (CHWs), and others are working toward this type of recognition and certification. This NASHP publication may be helpful in examining policies and strategies used in other states to develop partnerships between state leaders and CHWs leading to payment for their work.

Court Settlement: Missouri and Home Health Care for CMC
Seven children with medically complex conditions and the Caring for Complex Kids Coalition have reached a settlement with the Missouri Department of Social Services in the case S.J, et. al v. KnodellLegal Services of Eastern Missouri and the National Health Law Program filed the case on behalf of the children and the Coalition two years ago, arguing that the Medicaid Act and the Americans with Disabilities Act require the Missouri Medicaid agency to take steps to ensure that approved in-home nursing services are available. Among other things, the settlement agreement incorporates measures to improve the availability of in-home nursing and care coordination services for these children. You can find the complete statement HERE.

Key Websites: Public Health Emergency (PHE) Unwinding
Kaiser Family Foundation keeps two important websites up to date about what states are doing to communicate with families as the end of the PHE draws near: Ongoing or Planned Actions to Update Mailing Addresses and State Follow Up on Returned Mail. Take a look to know what your state is planning and doing.

NASHP created this publication about State Communication Strategies that is also helpful in laying out exactly what some states plan to do.

Brief and Webinar: Strengths of Hispanic families
A new brief from the National Research Center on Hispanic Children & Families reviews key findings from literature on Latinx families’ strengths and highlights the ways in which these strengths can protect children from adversity. The authors provide recommendations for programs and practices to build on Latinx families’ strengths and to guide researchers in advancing strength-based research. For example, programs should build on Latinx parents’ high levels of investment in their children’s futures and engage parents in programs by validating and encouraging these investments. 

Consider joining a related webinar by the Center focused on how current practices of asking about race and ethnicity causes confusion and is not relatable to many Hispanic families.

Understanding and Measuring Latino Identity October 6 from 1-2pm CST

Register HERE.

NASHP Brief: Patient Engagement- Telehealth
With support from a Patient-Centered Outcomes Research Institute (PCORI) award, the National Academy for State Health Policy (NASHP) engaged state officials representing Medicaid, the Children’s Health Insurance Program (CHIP), state-based marketplaces (SBMs), state employee health plans (SEHPs) and insurance departments, as well as key patient and advocate groups to learn more about how rapid changes to telehealth during COVID-19 might be sustained – or not.

NASHP sought to bring the patient perspective on telehealth to state official discussions as they seek to develop long-term telehealth policy within their own coverage programs and for the broader state. While there aren’t simple answers, the different perspectives are valuable. Themes of multiple discussions are shared in this brief, as are resources to help inform telehealth policymaking across states.

Collaboration: Child Trends and NYTimes on Child Poverty
Child Trends recently released a new research report, Lessons from a Historic Decline in Child Poverty, which analyzes the historic 59 percent decline in child poverty in the United States from 1993 to 2019. Co-lead authors Dana Thomson and Renee Ryberg found that the social safety net was largely responsible for this decline, although healthy economic conditions—including lower unemployment rates, increases in single mothers’ labor force participation, and increases in state minimum wages—also contributed. To help policymakers continue this progress, Thomson and Ryberg also offer policy recommendations. Child Trends also released a new interactive state data tool that shows how poverty declined among children in each state, alongside changes in economic and demographic conditions.
Jason DeParle of The New York Times featured Child Trends research in two new articles that explore child poverty around the United States. His first story examines the success of the social safety net since the 1990s and how it has helped three families stay above the poverty line. DeParle’s second story focuses exclusively on West Virginia families and how their lives have been impacted by poverty programs.

Thank you for subscribing to the Washington, DC Update newsletter. Please feel free to contact the Family Voices Director of Public Policy and Advocacy, Cara Coleman, with any questions. Past issues of the Update appear on the Family Voices website. If you wish to unsubscribe, you can do so via the "Unsubscribe" link below.

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.