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Washington DC Update 4/14/2021
Greetings from Washington, DC! 

The major issues covered in this Update are:
  • Extension of the Special Enrollment Period through August 15
  • Home and community-based services in the president’s American Jobs Plan
  •  Opportunity to provide feedback to sponsors of legislation on Medicaid home and community-based services
  • Information on new ACA premium tax credits
  • Modification of CDC guidance on COVID prevention in schools

Important links and reminders:

Registration now open for the 2021 Family Voices Leadership Conference! Join us for this virtual event on June 8, 10, 15 to share promising practices and celebrate the extraordinary achievements of families and professionals partnering to improve health care for all children, including CYSHCN. Explore sessions on health equity, supporting families during the pandemic, telehealth, family and youth engagement, organizational development, communication strategies, and impacting policy.

April is:

Thursday, April 15, 2021, is Purple Up! Day for HQ, Europe & Pacific, and the Americas. Select military installations or communities may decide to designate different days throughout the month.
The Administration
President Moves Up Date for All Adults to be Eligible for a Vaccine
During President Biden’s April 6 Remarks on the State of Vaccinations, he announced that, no later than April 19, everyone in this country age 18 and older will be eligible to “get in line” for a COVID vaccination.
Infrastructure proposal - Biden Pitches $400B Plan to Expand Medicaid Coverage of Home-Based Care Options (Skilled Nursing News, 03/31/21)
On March 31, President Biden unveiled the American Jobs Plan, a broad proposal to improve the nation’s infrastructure and promote economic recovery. 

See White House Fact Sheet, 03/31/21 (scroll about halfway down); What’s in Biden’s $2 trillion jobs and infrastructure plan? (Washington Post, 03/21/21). 
It will be up to congressional committees to develop legislation from the president’s proposal, and House Speaker Nancy Pelosi has indicated that she would like to see the House take up a bill before the July 4th recess. The president is expected to unveil a “social infrastructure” plan, which may include health-policy proposals.
(For more information, see Affordable Care Act section, below.)
CDC Extends Eviction Moratorium through June 30 (CDC press release, 03/31/21)
On March 28, CDC Director Rochelle Walensky, MD, MPH, signed an order to extend the CDC eviction moratorium through June 30, 2021, in order to ensure housing stability for renters and prevent further transmission, illness and deaths from COVID-19.
Members of Congress Seek Public Comments on Home and Community-Based Services (HCBS)
On March 16, Congresswoman Debbie Dingell (D-MI) and Senators Maggie Hassan (D-NH), Bob Casey (D-PA), and Sherrod Brown (D-OH) released a draft bill, the “HCBS Access Act,” which would make home and community-based services (HCBS) a mandatory Medicaid benefit. 
As a result, waiting lists would be eliminated in every state. (See a press release and one-page summary of the draft bill from the Autistic Self-Advocacy Network.)
The bill’s sponsors are seeking comments on the bill as a whole and on specific topics, including the services that should be covered, and how to address workforce shortages. 

Comments are due Monday, April 26, 2021, and should be submitted to [email protected]. 
Medicaid & CHIP
On March 18, the Center for Medicaid and CHIP Services (CMCS) issued an Informational Bulletin providing 2021 guidelines for the federal poverty level (FPL), which are used by states to determine eligibility for their Medicaid and CHIP programs.
American Rescue Plan is Lifting Children Out of Poverty: Will it Affect Their Medicaid Eligibility? (Georgetown Center for Children and Families, 3/16/21) (The short answer is NO.)
This issue brief discusses ways that states may use the additional funding, and provides state-by-state estimates of the potential impact of the policy change.
The National Academy for State Health Policy’s (NASHP) new Medicaid Managed Care Resource Center gives state leaders resources to develop and improve Medicaid managed care delivery systems, including nationwide scans of individual state policies, in-depth reports, and interactive maps.
Recently Issued or Updated Medicaid Resources from the National Academy for State Health Policy (NASHP):
Affordable Care Act/Private Insurance
Extension of COVID Special Enrollment Period
The administration has extended the COVID Special Enrollment Period (SEP) for the federal Marketplace at HealthCare.gov to August 15, 2021 (from May 15). See:
Several states have extended their special enrollment periods.
As explained in an April 1 HHS press release, the American Rescue Plan Act enacted last month increases tax credits to reduce premium costs.

See also:

From the Johns Hopkins Center for Health Security:
Update on pediatric trials of COVID-19 vaccines in the COVID-19 Situation Report of April 6, 2021
To receive these reports, sign up here.
COVID-19 Community Corps
On April 1, the U.S. Department of Health and Human Services (HHS) announced additional measures to encourage vaccinations and increase vaccine confidence.
These include the establishment of the COVID-19 Community Corps – a nationwide, grassroots network of local trusted, voices.

From the Centers for Disease Control and Prevention (CDC):
From the Food & Drug Administration (FDA):
Other News & Resources
Promoting Equity in Advocating for Public Policies
Voices for Healthy Kids and the American Heart Association have published a 2021 Racial Equity in Public Policy Message Guide (PDF) (February 2021), which offers advice for advocating with decision-makers to include racial equity in policymaking. Learn more.
State Fact Sheets on Pediatric Subspecialty Shortages
AAP and the American Board of Pediatrics developed state fact sheets illustrating the impact of pediatric subspecialty shortages on children’s access to health care. These fact sheets show how far children in each state need to travel to see pediatric subspecialists.

CDC and Other Guidance on School Operations
  • Revised physical distancing recommendations to reflect at least 3 feet between students in classrooms and provides clearer guidance when a greater distance (such as 6 feet) is recommended.
  • Clarified that ventilation is a component of strategies to clean and maintain healthy facilities.
  • Removed recommendation for physical barriers.
  • Clarified the role of community transmission levels in decision-making.
  • Added guidance on interventions when clusters occur.
For more information, see the “Schools and Child Care Programs,” page of the CDC website (last updated 04/05/21).
The Washington University School of Medicine has developed a new website, Safe Return to School for All, which summarizes best practices for returning safely to school based on information from the Washington University Intellectual and Developmental Disabilities Research Center, working with staff at the Special School District of St. Louis County, Missouri.
The Policy Lab at the Children’s Hospital of Philadelphia has updated its guidance on in-school operations -- Policy Review: Evidence and Guidance for In-person Schooling during the COVID-19 Pandemic – which provides a framework that can be adapted by local decision-makers and school leaders.

Other COVID Information:
CDC Mask Guidance (updated 04/06/21):

The Administration for Community Living (ACL) relaunched its COVID-19 site and reorganized resources to create a few new pages:
TRICARE and Military Health System
Your Input Sought
Due Monday, April 26 -- HCBS Access Act Comments 
On March 16, Congresswoman Dingell and Senators Hassan, Casey, and Brown released a draft bill, the “HCBS Access Act,” which would make home and community-based services (HCBS) a mandatory Medicaid benefit. 
As a result, waiting lists would be eliminated in every state.
The bill’s sponsors are seeking comments on the bill as a whole and on specific topics, including the services that should be covered, and how to address workforce shortages. 

Comments are due Monday, April 26, 2021, and should be submitted to [email protected].

See this one-page summary from the Autistic Self-Advocacy Network.
The HHS Office for Civil Rights (OCR) has announced a 45-day extension of the public comment period for the Notice of Proposed Rulemaking (NPRM) to modify the Health Insurance Portability and Accountability Act (HIPAA) Privacy Rule.

Among the proposed changes to the HIPAA Privacy Rule is facilitating greater family and caregiver involvement in the care of individuals experiencing emergencies or health crises. OCR encourages and will carefully consider comments from all stakeholders, including patients and their families.
Medicaid Learning Lab (about the roles Medicaid, and the Children’s Health Insurance Program play in providing health coverage to children, pregnant women, and families)
The Georgetown University Center for Children and Families
  • Thursday, April 15, 1:00 ET
  • Thursday, May 20, 1:00 ET
  • Thursday, June 17, 1:00 ET
Thursday, April 15, 2:00-3:00 ET
Child and Adolescent Health Measurement Initiative, with support from the Lucile Packard Foundation for Children’s Health
Thursday, April 15, 3:00 ET
Federal Communications Commission, Administration on Community Living
The Emergency Broadband Benefit is an FCC program to help households struggling to pay for internet service during the pandemic. This webinar will include an overview of the program. A brief question and answer period will follow the presentation.
To submit a question in advance of the webinar, please email: [email protected].
Friday, April 16, 1:15-2:45 ET
American Public Health Association, the George Washington University Milken Institute School of Public Health, MDB, and the Security and Sustainability Forum
Tuesday, April 20, 4:00 ET
Family Voices, CT KASA, and YASA (YASA- a program of Family Voices)
New! National Federation of Families: Education and Mental Health During COVID-19:
How are Children and Caregivers Doing, Really? 
Part 1 of 2: Tuesday, April 27, 2021 from 1:00-2:30pm ET 
Discussing the Effects of COVID 19 from the Family Perspective – Part One
Part 2 of 2: Friday, April 30, 2021, 2:30 - 4:00 p.m. ET
Discussing the Effects of COVID 19 from the Family Perspective – Part Two
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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.