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Washington DC Update 4/28/22
They’re back…

Both the House and Senate are back in session as April quickly gives way to May. Here are some of the major work ahead on the horizon.

The House Appropriations Committee is tentatively planning to take up its fiscal year (FY) 2023 spending bills in June, with the hope of possibly voting on the bills in July. To stick to the timeline means a LOT of work for those members of Congress on the appropriations committees. One of the tools being used right now is “Dear Colleague letters.” Such letters are crafted by champions of certain issues to garner support amongst their colleagues for the issue to be included in the appropriations bills.

Pandemic Aid
The Senate will look to regroup on passing additional supplemental funding for pandemic-related areas of need as the White House continues to push for additional assistance. The Bipartisan COVID Supplemental Appropriations Act failed to advance [47-52] in the Senate last month, and lawmakers are looking to regroup on the funding bill quickly. One major disagreement over the bill was related to the White House decision to end the Title 42 health directive at the U.S.-Mexico border. If an agreement can be reached, the bill is expected to pass in the Senate. On the House side, the way forward is unclear because current proposals lack funding for global health initiatives.

A bipartisan group of House and Senate lawmakers unveiled policy priorities for legislation that seeks to reduce the cost of insulin and limit out-of-pocket costs for diabetes patients. The lawmakers note that they are prioritizing the following policies within their proposed framework: (1) restricting the use of rebates for insurance plans and pharmacy benefit managers (PBM); (2) making insulin products eligible for cost-sharing and limiting copays or coinsurance to $35 per month; and (3) limiting the use of certain medical management requirements, including prior authorization. A Senate version of such a bill is expected soon. However, despite the bipartisan nature of this effort, it is too early to tell whether the forthcoming insulin pricing legislation will earn the 60 votes required for passage in the Senate.

Non-health related major bills: Technology and Small Business Aid
Lawmakers hope to produce a compromise version of the Senate's United States Innovation and Competition Act (USICA) and the House's America Creating Opportunities for Manufacturing, Pre-Eminence in Technology, and Economic Strength (America COMPETES) Act by July 4, Independence Day. Lawmakers are pushing to clinch legislation that would provide additional support for restaurants and other "hard hit" small businesses. The House has already passed a bill, and the Senate is expected to follow suit. 
From the Administration
HHS: Funding for Data-Driven Health Centers
The U.S. Department of Health and Human Services (HHS), through the Health Resources and Services Administration (HRSA), announced the availability of nearly $90 million in American Rescue Plan funding to support new data-driven efforts for HRSA Health Center Program-supported health centers and look-alikes (HRSA-designated health centers) to identify and reduce health disparities.
HRSA’s modernized data collection and reporting initiative, called Uniform Data System Patient-Level Submission (UDS+), is designed to collect more and better data on social determinants of health, while also streamlining and improving data quality reporting for health centers. This effort will enable health centers to tailor their efforts to improve health outcomes and advance health equity, more precisely targeting the needs of specific communities or patients.

The enhancements that health centers may make to their infrastructure using ARP-UDS+ funds will support patient-level reporting and enable them to better identify, measure, and investigate disparities in health care use and health outcomes by race, ethnicity, age, and other important demographic factors, and to more precisely target their resources accordingly. Standardization of patient-level health data will enable the identification of populations most at risk for health disparities and will provide data to inform potential clinical interventions. Furthermore, the ability to collect, house, and report standardized patient-level health data will support health centers’ participation in critical population health surveillance activities during public health emergencies.

HRSA-supported health centers serve medically underserved populations and communities, which are often disproportionately affected by COVID-19. Health centers serve 1 in 5 people living in rural communities, and 1 in 11 people nationwide. More than 90% of HRSA-funded health center patients are individuals or families living at or below 200% of the Federal Poverty Guidelines, and nearly 63% are racial or ethnic minorities.

Applications are due in HRSA's Electronic Handbooks by 5:00 p.m. ET on Monday, May 23, 2022. Visit the American Rescue Plan UDS+ Supplemental Funding technical assistance webpage for the notice of funding opportunity, technical assistance information, and other resources.

HHS: Health Care Provider Climate Change Pledge
The Department of Health and Human Services (HHS), in partnership with the White House, is issuing a call to action for health care stakeholders to commit to tackling the climate crisis through a new initiative aimed at reducing emissions across the health care sector. The health care sector contributes 8.5% of total U.S. emissions. U.S. hospitals, health systems, suppliers, pharmaceutical companies, and other industry stakeholders are invited to submit pledges to reduce greenhouse gas emissions and increase their climate resilience.

The voluntary pledge asks signees to, at a minimum, commit to (1) reducing their organization’s emissions (by 50% by 2030 and to net-zero by 2050) and publicly reporting on their progress; (2) completing an inventory of Scope 3 (supply chain) emissions; and (3) developing climate resilience plans for their facilities and communities. It also asks them to designate an executive lead for this work.
Starting with the establishment of the Office of Climate Change and Health Equity (OCCHE) in August of 2021, HHS is taking a more active role to address the challenges climate poses to health. The Department expects to make more climate-readiness resources and technical assistance supports available to health care providers in the coming months.

Pledge signers can download forms and find more information on the submission process here. Forms will be due by June 3, 2022.

In Case You Missed It: Unwinding of the Public Health Emergency (PHE) Extended
CMS is committed to ensuring access to comprehensive health care coverage by providing partners with guidance and resources as they plan for the eventual end of the COVID-19 PHE and the Medicaid continuous coverage condition established under the Families First Coronavirus Response Act. The Department of Health and Human Services (HHS) has committed that it will provide states with 60 days of notice before any planned expiration or termination of the PHE to give states as much lead time as possible. In line with that commitment, CMS will be communicating early and often with states and other partners to support the planning and coordination of this unwinding process. This communication is a part of ongoing outreach. The current expiration date is July 15, 2022.
Key Resources: CMS created an Unwinding homepage with tools and resources.

  • On this page, you can find the Communications Toolkit and graphics to help partners begin reaching out to Medicaid and CHIP beneficiaries so that they are prepared for upcoming renewals, along with several other unwinding resources.
  • The toolkit and graphics are available in both English and Spanish.

Public Health Emergency (PHE) Unwinding Related Issue Brief: Whether a state’s Medicaid agency moves swiftly or slowly to process eligibility redeterminations, the commercial insurance market–and particularly the ACA Marketplaces–could experience significant growth in enrollment. In a new issue brief for the State Health & Value Strategies project, Georgetown Center for Health Insurance Reforms’ Sabrina Corlette identifies several areas where state insurance regulators will want to coordinate with other agencies or external stakeholders, issue new regulations or guidance, and establish means for minimizing gaps in coverage or access to services.
Webinars of Interest
ACL: Home and Community-Based Services (HCBS) Quality Measures Webinar
When: Tuesday, May 3 | 2:00 p.m. – 3:00 p.m. ET
The quality of life of older adults and persons living with all types of disabilities is closely tied to the services they receive in home and community settings. Among these services are residential supports, personal care services, mental health services, and community living supports.

Despite its importance, the quality of home and community-based services (HCBS), as well as the outcomes for older adults and people with disabilities who receive them, have historically been difficult to define and even more difficult to measure.

Through working with researchers, measure developers, policymakers, and advocates, the Research and Training Center on HCBS Outcome Measurement (RTC/OM) at the University of Minnesota Institute on Community Integration has developed measures that focus on how well Home and Community-Based Services (HCBS) are helping older adults and people with a variety of disabilities live the lives they want.
This webinar will:

CMS: Prioritizing Childhood Mental Health: Encouraging Use of Mental and Behavioral Health Benefits Covered Under Medicaid and CHIP
When: Wednesday, May 4 | 3:00 p.m. – 4:00 p.m. ET
The Campaign is hosting a webinar featuring new data on the impact of the Public Health Emergency (PHE) on youth mental health, strategies for improving access to and use of mental and behavioral health services, resources for suicide prevention, practices to support youth mental health, and Campaign resources available on InsureKidsNow.gov for organizations to use in their outreach, especially during May, which is Mental Health Awareness Month. 

Mental Health and Developmental Disabilities National Training Center (MHDD-NTC): Parenting with Co-occurring Mental Health and Developmental Disabilities
When: Tuesday, May 10 | 2:00 p.m. – 3:00 p.m. ET
This webinar will focus on the experiences of parents and families who have lived experience with co-occurring mental health and developmental disabilities. They will discuss their families, the strategies they used, and assistance they received to become successful parents, but also the bias and discrimination they have experienced.

Webinar Objectives:

  1. Define eugenics and its relationship to the forced sterilization of people with disabilities in the United States;
  2. Identify instances of bias and discrimination against individuals with disabilities becoming parents;
  3. Identify successful strategies, including the use of assistive technology, in becoming successful parents; and
  4. Identify barriers parents with disabilities face in supporting their families, especially if their children have disabilities themselves.

This webinar is hosted by the Mental Health and Developmental Disabilities National Training Center (MHDD-NTC). Learn more at mhddcenter.org. The MHDD-NTC is funded by the Administration for Community Living.

ACL: Identifying and Implementing Diversity, Equity, and Inclusion Strategies to Promote Cultural Humility & Awareness
When: Tuesday, May 10 | 3:00 p.m. – 4:30 p.m. ET
Join the DETAC along with the Association of University Centers on Disabilities (AUCD), the Center for Leadership in Disability at Georgia State University, and the Washington Initiative for Supported Employment to learn about resources and tips for a focused approach to building and implementing DEI to promote cultural humility and responsiveness. As grantees, supporting people from marginalized and underserved populations can be challenging without the right tools, especially when resources are scarce. Yet, there is a high need for cultural awareness and support when providing employment planning services. This webinar will help participants understand how to apply the resources shared and will further guide audience members to think through next steps in implementing some of the strategies presented.
Issue Brief of Interest
Manatt Newsletter and Issue Brief: Health Equity & 1115 Waivers
In a new issue brief for the Robert Wood Johnson Foundation’s State Health and Value Strategies program, summarized here, Manatt Health examines Medicaid’s role in promoting health equity and describes ways states can center and advance health equity and address structural racism through each Section 1115 demonstration’s life cycle stage, which include planning, implementation and monitoring, and evaluation. A companion issue brief, Centering Health Equity in Medicaid: Section 1115 Demonstration Strategies, provides insights into specific, innovative policies to advance health equity that states can implement through Section 1115 demonstrations. The insights and recommendations found in both documents are informed by recent interviews with federal and state policy makers and secondary research and analysis.

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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.