Washington DC Update 7/13/22 |
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Congress returns this week for the sprint between Independence Day and August Recess, in which the House and Senate both try to crank through legislative “to-do lists” before the late summer break.
Reconciliation
In the Senate, July is heating up with discussions of reconciliation. No longer called “Build Back Better” there are renewed talks of a reconciliation bill (brief refresher: the democrats have been on a long journey trying to use the budget reconciliation process to pass a filibuster-proof package that contains elements of President Joe Biden's economic agenda). Not a lot of information is known about the details of this version, but in terms of health care policy, it appears that prescription drug pricing may be included, as well as ACA Premium Tax Credits (PTCs) discussed in this Georgetown Center on Health Insurance Reforms blog post.
Appropriations
House lawmakers are expected to consider a small package of spending bills for fiscal year (FY) 2023 during the week of July 18. This first House package will include Transportation, Agriculture, Energy-Water Development, Financial Services and General Government, Interior Environment and Military Construction. Last month, Senate Appropriations Chair Pat Leahy (D-VT) stated that his committee could begin the markup process during this July work period.
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July means… 988 Implementation!
Beginning July 16, the telephone number to reach the National Suicide Prevention Lifeline, an existing hotline composed of a network of call centers, will shift to 9-8-8 across states. This three-digit number will be adopted universally and will connect individuals to call centers staffed by trained crisis workers or volunteers.
Want to see how your state is preparing? Consider reading through the following two publications from the National Academy for State Health Policy.
CMS: Improving MCO reporting
The U.S. Department of Health and Human Services (HHS), through the Centers for Medicare & Medicaid Services (CMS) unveiled a suite of new resources to improve CMS and state oversight of Medicaid and Children’s Health Insurance Program (CHIP) managed care programs. The Center for Medicaid and CHIP Services Informational Bulletin (CIB) includes tools, templates, and updates on tactics to improve states reporting on their managed care programs, which promotes access to care for millions of people enrolled in Medicaid and CHIP. Some highlights include:
- The CIB offers reporting templates and a new technical assistance toolkit to help states improve their overall monitoring and oversight of managed care. The managed care reporting templates will provide a standard format for states to report managed care medical loss ratios (a measure that helps encourage health plans to provide value to enrollees) and network adequacy (a measure of how well a plan delivers its actual benefits) to CMS.
- To promote transparency in Medicaid and CHIP, the CIB also reminds states of the requirement to post their Network Adequacy and Access Assurances reports on a state website for each program they operate. CMS will make all reports submitted through Managed Care Reporting available after an initial review of reports are complete. CMS will be creating a webpage on Medicaid.gov where states will be able to review the reports. Reports are currently available upon request.
- As an additional step to aid states and the individuals many Medicaid and CHIP programs serve, CMS also released a toolkit to support program monitoring for Medicaid enrollees in Managed Long-Term Services and Supports (MLTSS) —specific managed care programs that can help ensure more people with long-term care needs transition from institutions to home and community-based settings. The toolkit, “Promoting Access in Medicaid and CHIP Managed Care: Managed Long-Term Services and Supports Access Monitoring Toolkit,” was developed in response to MLTSS growth and federal oversight concerns about access to services and quality of care.
You can find the CIB HERE.
CMS: Updates to Improve the Safety and Quality of Care for Long-Term Care Residents
As part of the Biden-Harris Administration’s initiative to promote the safety and quality of nursing home care across the country, the Centers for Medicare & Medicaid Services (CMS) issued updates to guidance on minimum health and safety standards that Long-Term Care (LTC) facilities (often called “nursing homes”) must meet to participate in Medicare and Medicaid. CMS also updated and developed new guidance in the State Operations Manual (SOM) to address issues that significantly affect residents of LTC facilities. The surveyors who use these resources to perform both routine and complaint-based inspections of nursing homes are responsible for determining whether facilities are complying with CMS requirements.
Some highlights include:
- To begin helping address the staffing issue while the rulemaking process is underway, CMS added new requirements for surveyors to incorporate the use of Payroll Based Journal staffing data for their inspections. This will help better identify potential noncompliance with CMS’s nurse staffing requirements, such as lack of a registered nurse for eight hours each day, or lack of licensed nursing for 24 hours a day. This guidance will help to uncover instances of insufficient staffing and yield higher quality care.
- Using lessons learned from the pandemic, CMS is providing further guidance requiring each facility to have an Infection Preventionist (IP) who has specialized training to effectively oversee the facility’s infection prevention and control program—in accord with President Biden’s campaign commitment to ensure facilities have sufficient on-site IPs.
- CMS has highlighted the benefits of reducing the number of residents in each room for preventing infections and the importance of residents’ rights to privacy and home-like environment. The pandemic has further proven the risk of contracting infectious diseases in rooms with several residents. CMS is urging providers to consider making changes to their settings to allow for a maximum of double occupancy in each room and encouraging facilities to explore ways to allow for more single occupancy rooms for nursing home residents.
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The updates also contain improvements to CMS guidance for mental health and substance use disorder, and builds upon the agency’s Behavioral Health Strategy to better meet the unique needs of LTC facility residents with mental health and substance use challenges. CMS also clarified the minimum level of knowledge and skills of facility staff to ensure that the policies and practices do not conflict with resident rights or other participation requirements.
LTC facilities and state survey agencies can review each change in the advance copies attached to the CMS QSO-22-19-NH memorandum. The online SOM will be updated on or after October 24, 2022, when these changes go into effect. Surveyors will begin using the guidance and changes, which will be incorporated into the survey process, on October 24, 2022.
Administration for Community Living (ACL): Expanded Availability of At-home COVID-19 Tests for People Who Are Blind or Have Low Vision
Last month, the Biden-Harris Administration launched an initiative to expand the availability of at-home testing options that are more accessible for people who are blind or have low vision. The tests work with a Bluetooth-enabled smartphone app to provide users with audible instructions and test results. Read more about the tests.
Due to very limited supplies when the program began, each order included only two test kits. People were asked to order these tests only if they did not have options for using the traditional kits. Starting today, the program is expanding. People will now receive 12 test kits with each order. In addition, anyone who is blind or who has low vision is now encouraged to order the more-accessible tests.
How to get the tests:
Order online or by calling 1-800-232-0233.
- Each order now includes 12 rapid-antigen tests that are more accessible for people who are blind or have low vision. These will ship in six separate packages, each with two tests. Each package will have a separate tracking number.
- Orders will ship free, while supplies last.
Need more assistance?
The trained staff at the Disability Information and Access Line (DIAL) can provide additional assistance with:
- Ordering tests.
- Understanding instructions for test administration and test results.
- Providing alternative instructions for traditional at-home tests for people who are unable to access, read, or understand the manufacturer’s version.
- For those who cannot use an at-home test, DIAL operators can:
- Assist with ordering “swab and send” kits to collect a sample and mail it back for results.
- Connect callers to local organizations for assistance locating other testing options in their community, including in-home testing programs or transportation or companion support to visit a community-based testing site.
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Blog Posts, Reports, and Fact Sheets of Interest |
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Fact Sheet: Voters Strongly Support Making Investments in Our Children and Grandchildren
Created by First Focus on Children, this fact sheet provides some great data and insights that could be used in many ways to advocate for more focus, and budget focus, on children’s health.
Blog Post: Medical Debt is OFF Your Credit Score!
This blog post by Community Catalyst shares that as of July 1, 2022, all paid medical debt will be removed from credit reports with the top 3 credit reporting agencies- Experian, Equifax, and TransUnion. The time period that it will take for a medical debt to be placed onto a credit report will also increase from 6 months to a full year after the initial invoice.
National Academy for State Health Policy (NASHP): New Public Health Modernization Project
Although the pandemic has spurred new collaborations, it has also revealed longstanding gaps in the nation’s public health infrastructure and disparities in access to care. Historic underinvestment in public health systems, a depleted workforce, and antiquated data systems are just a few of the challenges that have hindered the public health response to COVID-19. The demands of the pandemic have made it clear that the public health system cannot work in a silo to do the foundational public health work of communicable disease prevention; maternal, child, and family health services; access to and linkage with clinical care; and preventing chronic disease and injury. By finding innovative ways to combine the efforts of public health, health care, and community partners around common priorities, states can be better prepared to respond to the next emergency and develop sustainable approaches for preventing costly conditions that significantly impact individual health and community resilience.
To support state leaders in these efforts, the National Academy for State Health Policy (NASHP), with support from the Commonwealth Fund, is launching a new project focused on improving cross-sector alignment, coordination, and collaboration between public health and health system stakeholders on key public health goals. Drawing on the input and feedback of a diverse state leaders working group, as well as key partners and public health experts, NASHP will develop a toolkit for state leaders and launch a 12-month learning collaborative in Fall 2022 to provide technical assistance to up to five cross-agency state teams as they identify and implement their public health modernization priorities. You can find more information about the project HERE.
Bazelon Center & Legal Defense Fund Release Report: Advancing An Alternative to Police: Community-Based Services for Black People with Mental Illness
Studies show that Black people and people with mental illness are both more likely to experience harmful interactions with law enforcement that can lead to injury, incarceration, or death. Black people with mental illness are at particularly high risk for arrest and incarceration during such encounters. Black people have also historically faced racial discrimination and accompanying trauma by mental health professionals and the healthcare system at large. To protect Black people with mental illness and help them thrive, states and local governments must invest in comprehensive, culturally competent mental health systems to prevent emergencies from occurring and to respond when emergencies occur.
July is National Minority Mental Health Awareness Month. Learn more from their report about how a robust community-based mental health services system can be a meaningful alternative to a law enforcement response for Black people with mental illness.
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Briefing and Webinars of Interest |
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Medicaid and CHIP Congressional Briefing
Thursday, July 14, 2022
12 p.m. ET | 9 a.m. PT
Join us for a Hill Briefing on how a reconciliation package could include Medicaid and CHIP policies to support children and families. The briefing is jointly hosted by the Association for Community Affiliated Plans, the American Academy of Pediatrics, the Children's Hospital Association, First Focus Campaign for Children, Families USA, Community Catalyst, the National Alliance on Mental Illness, and the Adult Vaccine Access Coalition.
Bazelon Center & Legal Defense Fund: Keeping Olmstead's Promise: Ending Police Violence Against Black Disability Communities with Community-Based Services
Thursday, July 14, 2022
12 p.m. ET | 9 a.m. PT
The ADA at 32: Achieving accessible, integrated and affordable housing for people with disabilities
Tuesday, July 26, 2022
2 p.m. ET |11 a.m. PT
The Consortium for Constituents with Disabilities Housing and Rights Task Forces invite you to a virtual briefing in celebration of the 32nd Anniversary of the Americans with Disabilities Act (ADA) to discuss the ADA’s impact on accessible, integrated, affordable, and safe housing within the United States. This event will highlight a panel of experts, including people whom themselves experience disabilities and challenges in accessing quality housing options.
This year’s presenters are:
- Allie Cannington, Manager of Advocacy & Organizing The Kelsey
- Sandra Conley, Intern, American Association of People with Disabilities
- Carlean Ponder, Director of Disability Rights and Housing, The Arc of The United States
- Sarah Malaier, Senior Advisor, Public Policy and Research, American Foundation For The Blind
Congressional Co-Hosts are Senators Patty Murray (D-WA), and Bob Casey (D-PA), and Representative Maxine Waters (D-CA)
CMS: Back-to-School with Medicaid & CHIP: Ensuring Kids are Covered, Vaccinated and Ready to Learn
Tuesday, July 26, 2022
2 p.m. ET |11 a.m. PT
Children and teens can enroll in Medicaid and the Children’s Health Insurance Program (CHIP) at any point in the year and many organizations have found the Back-to-School season as an opportune time to connect with families to share enrollment information – especially highlighting key benefits like vaccinations, vision, and dental care. It is also an important time to remind Medicaid and CHIP beneficiaries about the need to renew their coverage once states resume normal eligibility and enrollment operations upon the conclusion of the Public Health Emergency.
This webinar will provide attendees with an in-depth overview of Campaign and partner resources, including a demonstration of InsureKidsNow.gov features, with a focus on resources to promote vaccinations, details on material customization capabilities, and an overview of CMS’ Medicaid and CHIP Continuous Enrollment Unwinding Communications Toolkit to support partners and states in preparing for unwinding of the Public Health Emergency. Additionally, the webinar will feature a current grantee sharing their own experiences and best practices utilizing Campaign resources. Partners and grantees play a crucial role when it comes to connecting children to coverage.
Webinar speakers:
- Georgina Peacock, MD, MPH, Director, Immunization Services Division, Centers for Disease Control and Prevention National Center for Immunization and Respiratory Diseases
- Stefanie Costello, Office of Communications, Partner Relations Group, Centers for Medicare & Medicaid Services
- Emily Roller, Health Insurance Program Manager, Virginia Health Care Foundation
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Porter Novelli Public Services, Outreach Contractor, Connecting Kids to Coverage National Campaign
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Transportation Policy: Mobility, Accessibility & Demand Response Transportation Conference
Monday, September 12 - Friday, September 16
- Engage in discussion and solution building with international leaders regarding accessible transportation globally.
- Participate in research forums to exchange ideas and data regarding accessible transportation solutions.
- Hear state-of-the-art strategies and solutions to address international mobility and transportation challenges.
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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.
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