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Washington DC Update 2/22/2021
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The Centers for Disease Control and Prevention (CDC) has created a new webpage for coping with stress in the difficult times resulting from the COVID-19 pandemic.

Greetings from Washington, DC. The major issues covered in this Update are:
  • The COVID-relief bill
  • New CDC guidelines on school reopening
  • New CDC guidance on masks
  • Withdrawal of public charge rule
  • Rescission of Medicaid work-requirement waivers and guidance
  • Vaccination and mask updates (end section) – double-layer or double-masking advised

Due March 4, 2021, 5:00 pm ET -- Solicitation of Nominations for Appointment to the Advisory Committee on Minority Health (Federal Register, 12/04/20).

REMEMBER – There Is a New Special Enrollment Period (SEP): Feb. 15 - May 15. 
See the ACA section, below, for more information and tools to spread the word, such as this easy-to-understand fact sheet from the Young Invincibles
Warning from the FDA: List of hand sanitizers consumers should not use
There are more than 225 hand sanitizers the FDA recommends you stop using right away.

Bookmark www.fda.gov/handsanitizerlist for the latest, and use this step-by-step search guide to find out if your product is on the list. Note that some packages that look like food actually contain hand sanitizer.
CDC Issues New Guidance on School Re-openings
On February 12, the Centers for Disease Control and Prevention (CDC) released a new Operational Strategy for K-12 School through Phased Mitigation, which replaces the core indicators issued in September 2020. A controversial feature of the new guidelines is the recommendation that extra caution be taken in opening middle and high schools in areas with a high degree of COVID transmission.

See New CDC guidance ends up deepening debate over reopening schools (The Hill, 02/16/21). There has also been controversy over the administration’s position that teachers do not need to be vaccinated before schools reopen.

Monday webinar on this topic:

Executive Order Aimed at Reversing Public Charge Rule
On February 2, President Biden Executive Order on immigration issues that directs federal agencies to review the “public charge rule,” which has deterred immigrants from accessing public benefits for themselves and their citizen children because they fear that doing so will hurt their chances of gaining permanent residency. To completely rescind the pubic charge rule will require a time-consuming administration process.

See President Biden’s Executive Order on Public Charge (blog of the Georgetown Center for Children and Families, 02/08/21). For more information about the current rule, see Public Charge Update: What Advocates Need to Know Now (02/02/21) and Immigrant Eligibility for Public Programs During COVID-19 (updated 02/02/21) from the Partnership to Protect Immigrant Families, and an FAQ about public charge and health benefits (Feb. 2021) and other resources from the Center on Budget and Policy Priorities.

It has been reported that President Biden plans to nominate Chiquita Brooks-LaSure to serve as administrator of the Centers for Medicare and Medicaid Services, which oversees Medicare, Medicaid, and the Affordable Care Act (ACA). Brooks-LaSure has expertise in all of these programs.

Administration Names Members of COVID-19 Health Equity Task Force
In January, the president issued an Executive Order to establish a COVID-19 Health Equity Task Force, and on February 10, the non-federal members of the Task Force were named. Among them is Andy Imparato, former Executive Director of the Association of University Centers on Disabilities and staffer for disability-rights advocate and former Senator Tom Harkin. Federal Task Force members are the Secretary of HHS and other relevant government officials that he or she may invite.
CDC Extends Eviction Moratorium; President Extends Foreclosure Moratorium & Mortgage Forbearance 
Eviction Moratorium. On January 20, CDC Director Rochelle P. Walensky, MD, MPH, announced an extension of the order temporarily halting residential evictions until at least March 31, 2021, as a protective health measure. In order to take advantage of the moratorium, tenants must provide a declaration to their landlord. 

Please note: Administration actions regarding COVID vaccinations are in the “Vaccines” section below.
The Courts

On February 10, 2021, the Department of Justice notified the Supreme Court that it has formally changed its position in California v. Texas, the case challenging the constitutionality of the Affordable Care Act (ACA). Normally, an administration defends laws, but the Trump administration had taken the unusual position of siding with the Republican state attorneys-general who challenged the ACA. The court below ruled that the entire law is unconstitutional, but many legal observers do not expect the Supreme Court to agree, even if it rules parts of the law to be unconstitutional. 

See Supreme Court Arguments: Even If Mandate Falls, Rest Of Affordable Care Act Looks Likely To Be Upheld (Health Affairs blog, 11/11/20). Because the Court heard oral argument in the case in November, it is considered unlikely that the change in the administration’s position will have an impact on the decision, which could be issued at any time.
During the past two weeks, House committees have been reporting out their respective portions of the next COVID-relief bill, based on the president’s “American Rescue Plan.” These bills will be bundled into a single “reconciliation” bill by the House Budget Committee. Subsequently, the House Rules Committee may make some changes to the bill and send it to the House Floor, where it is expected to pass. 

The final House bill is expected to include some significant, but largely temporary, health-related and other provisions that will help families, including:

  • $1400 stimulus payments to individuals, including adult dependents;
  • Medicaid funding dedicated to home and community-based services;
  • 12-month postpartum Medicaid eligibility (for 5 years);
  • Medicaid coverage for vaccines and COVID treatment;
  • Incentives for states to take up the ACA Medicaid expansion;
  • Subsidies for COBRA coverage;
  • More generous ACA premium tax credits;
  • Funding for public health, including community health centers, the public health workforce, mental health and substance use services, tribal health centers, and the Indian Health Service;
  • Emergency paid leave;
  • An increase in the child tax credit; and
  • Funding for states and localities to help them avoid cuts in essential services.

The House is expected to pass the bill at the end of next week, and it will then move directly to the Senate Floor (bypassing committees). The Senate is expected to amend the House bill, in part because some of the moderate (more conservative) Democrats may object to expensive provisions that do not have a relatively immediate and short-term impact. Due to the 50-50 Democrat-Republican split in the Senate, with the vice-president breaking tie votes, a single Democrat can have a great deal of influence over legislation. Other provisions (e.g., the minimum-wage increase) may have to be removed from the bill due to the Senate’s “Byrd Rule” which requires that all provisions in “reconciliation” bills be budget-related. The reconciliation process is being used for this legislation because it is unlikely that there will be enough bipartisan support to get the 60 votes needed to advance other types of legislation.

The goal is to have the bill enacted by March 14, when special pandemic-related unemployment benefits are due to expire. See House aims to vote on Covid relief bill by the end of next week, Pelosi says (CNBC, 02/18/21); Where things stand on the COVID-19 relief measure (The Hill, 02/17/21).
Medicaid & CHIP
Medicaid Work Requirements – Administration Action and Supreme Court Case
The Biden administration has taken measures to reverse the previous administration’s approval of Medicaid waivers allowing states to establish work requirements as a condition of receiving Medicaid benefits. These measures could make moot a case challenging these work requirements in which that the Supreme Court is scheduled to hear oral arguments on March 29.

Finding and Analyzing Medicaid Quality Measures for Advocates
The National Health Law Program has developed a brief with tools that enable advocates to find state and plan-level Medicaid quality data, learn how to evaluate and compare results, and use those skills to improve data transparency and push states to hold plans accountable for managing care effectively and efficiently.

Affordable Care Act/Private Insurance
New Special Enrollment Period (SEP): Feb. 15 - May 15
This new SEP applies to the 36 states using the Healthcare.gov exchange or platform. Other states may choose to open their enrollment periods. These states and their enrollment periods are listed on page 2 of this fact sheet from the Young Invincibles – New COVID Open Enrollment Period: An Explainerwhich provides suggested media messages. 

Community Catalyst has additional Social media graphics and digital content and a social media messaging guide and are NEW graphics for this SEP.


Johns Hopkins COVID-19 Vaccine Prioritization Dashboard (Johns Hopkins University, updated regularly)

State COVID-19 Vaccine Priority Populations (Kaiser Family Foundation, updated regularly)
State Plans for Vaccinating their Populations against COVID-19 (National Academy for State Health Policy, last updated 02/08/21)

The Next Phase of Vaccine Distribution: High-Risk Medical Conditions (KFF Feb 16, 2021) (Finds that states are all over the map, so to speak, regarding which conditions qualify someone to get a vaccine.)

If you got vaccinated in the last 6 weeks, you can participate in v-safe
V-safe (https://vsafe.cdc.gov/) is a CDC smartphone-based tool that checks in on you after your COVID-19 vaccination. Your participation helps keep COVID-19 vaccines safe — for you and for everyone.

Tribal-specific resources on COVID-19 vaccines

Get Vaccinated to Protect Yourself, Family, and Community, which highlights the safety of COVID-19 vaccines and provides tips for coping with anxiety related to vaccination.           

The COVID Collaborative, alongside UnidosUS and the NAACP, has released a report on Coronavirus Vaccine Hesitancy in Black and Latinx Communities.

Specialized Vaccine Resources

Vaccine Misinformation Alerts and Resources, from the Public Health Communications Collaborative:
Other News & Resources
The National American Indian and Alaska Native Mental Health Technology Transfer Center Network's K-12 School Initiative offers a year’s worth of free telehealth mental health services to children and youth in grades K–12. The services will allow children and adolescents to connect via cell phone with counselors, therapists, or social workers. Interested providers who work in school or community health care programs for Native youth are encouraged to email Teresa Brewington for more information.

The US Administration for Community Living (ACL) requested input for its report, In Their Own Words: Caregiver Priorities and Recommendations: Results from a Requests for Information, as it works to implement the requirements of the Recognize, Assist, Inform, Support and Engage (RAISE) Family Caregivers Act of 2017. [Note: Family Voices submitted a response to the Request for Information mentioned above.]
COVID-Related Resources:
From the CDC: COVID-19 Data Tracker Weekly

Starting Friday, February 12, 2021, COVIDView was replaced with the COVID Data Tracker Weekly Review. This new webpage and newsletter highlight key data from CDC’s COVID Data Tracker, narrative interpretations of the data, and visualizations from the week. It will bring together daily CDC data and reporting in a centralized location.
Sign up to have the COVID Data Tracker Weekly Review delivered to your inbox every week.
Accessible COVID Information
The Center for Inclusive Design and Innovation (CIDI) at Georgia Tech University has developed a website providing accessible COVID-19 information.

Accessible Word and PDF documents and Easy-to-Read Information are on the website, resources in Braille can be ordered, and ASL resources are being developed.
The CDC has developed COVID-prevention guidelines for Large or Extended Families Living in the Same Home.
Visitation at Intermediate Care Facilities: On February 2, CMS issued new guidance for visitation in intermediate care facilities for individuals with intellectual disabilities (ICF/IIDs) and psychiatric residential treatment facilities (PRTFs) during the COVID-19 Public Health Emergency (PHE). The guidance provides ways an ICF/IID and PRTF can more safely facilitate in-person visitation and address the psychosocial needs of clients/residents. CMS encourages all ICF/IIDs and PRTFs to monitor the CDC website for information and resources and contact their health department when needed.
ADvancing States has an excellent webpage listing federal guidance related to COVID-19 from multiple agencies.
News on Improving Mask Effectiveness: The CDC recently released updated guidance on how to correctly wear your mask.

See Improving the fit and filtration of your mask to reduce the spread of COVID-19. CDC recommends masks with two or more layers and that fit snugly against your nose and sides of your face. Fit can be improved by wearing two masks (cloth mask over a medical mask). The CDC recommends against combining two disposable masks and says that an N95 or KN95 mask should not be combined with any other mask. CDC also released an MMWR and published an article in JAMA about mask effectiveness, and has updated some of its mask information:

The Centers for Disease Control and Prevention (CDC) issued an Order [PDF – 11 pages] on January 29, 2021, requiring the wearing of masks by travelers to prevent spread of the virus that causes COVID-19. 
TRICARE and Military Health System
Due March 4, 2021, 5:00 pm ET -- Solicitation of Nominations for Appointment to the Advisory Committee on Minority Health (Federal Register, 12/04/20).
Monday, February 22, 3:30 ET
Centers for Disease Control and Prevention (CDC)

Monday, February 22, 4:00 ET
National Academy for State Health Policy

February 22–24, 2021; Forum Agenda
Centers for Disease Control and Prevention (CDC)
If you are unable to attend the event, but want to receive meeting recordings and materials when available, please visit the National Forum on COVID-19 Vaccine website to find event materials and session recordings after the event or to indicate that you cannot attend the meeting but would like information on how to receive the materials.

Wednesday, February 24, 2:00-3:00 ET
State Health and Value Strategies

Thursday, February 25 2:00-3:15 ET
FDA’s Office of Minority Health and Health Equity

Substance Abuse and Mental Health Services Administration (SAMHSA)

Tuesday, March 2, 7:30pm - 9:00pm ET

Robert Wood Johnson Foundation Systems for Action Research Program
Wednesday, March 10, 1:00-2:00 ET
National Family Support Technical Assistance Center
Friday, March 19, 10:00-12:00 ET
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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.