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Washington DC Update 7/21/21
It’s getting HOT in here…

Summer and climate change are not the only reasons things are
heating up in Washington, DC right now. 
On Fire: Budget Reconciliation, Infrastructure, and Home & Community-Based Services (HCBS)
Senator Schumer and the Senate Budget Committee announced reaching agreement on a $3.5 trillion dollar cap on the budget reconciliation bill. If you recall, reconciliation is the legislative process that requires the support of just a simple majority of democratic senators (50) and is not subject to filibusters. The details have not yet been shared publicly, but the budget reconciliation bill includes funding for programs such as subsidies for child care, universal prekindergarten education, two years of free community college, paid leave, home health care, workforce development programs, and expanding Medicare coverage of dental, vision and hearing benefits. Simple majority may not be so “simple” and there is word that some of the negotiation to reach that simple majority includes decreasing the proposed $400 billion for home & community-based services (HCBS) to less than half that proposed in the Better Care Better Jobs Act. 

Step into the heat for HCBS! As the Huff Post article points out, STORIES that educate Senators about the role of HCBS in your life are the way to make a difference NOW! Reach out and educate your Senator right now--regardless of whether they have already signed on to sponsor. NOTE: Although HCBS is moving along right now as a partisan issue in the Senate, we know that HCBS is not a partisan issue, so step into the heat for HCBS with all of your bipartisan members of Congress. Stories of real-life HCBS must be at the forefront of their mind!

NOTE: The infrastructure bill is not part of reconciliation. That bill, focused on roads, bridges, public transit, broadband, water, and power infrastructure, is bipartisan and will follow a different process. 
More heat on Supporting Direct Care Workforce through training
Senator Tim Kaine (D-VA) introduced the Supporting Our Direct Care Workforce and Family Caregivers Act on July 14, 2021, which would authorize over $1 billion in supporting the direct care workforce and family caregivers. Specifically, the bill outlines that the U.S. Department of Health and Human Services (HHS), through the Administration on Community Living (ACL), will award grants to states, or other eligible entities, to build, retain, train, and otherwise promote the direct care workforce (including self-directed workers and direct care supervisors or managers). Notably, this educational and training support is for both paid and unpaid family caregivers.
In the frying pan: Medicaid in the Territories
Medicaid programs in the Territories--Puerto Rico, American Samoa, Guam, Northern Mariana Islands, and U.S. Virgin Islands--are facing a looming "fiscal cliff." The expiration of temporary Medicaid increases in the Territories would return them to their base block grants. Data indicates that this would represent reductions in federal Medicaid funding of 85% for American Samoa, Guam, and the U.S. Virgin Islands; 88% for the Northern Mariana Islands; and 86% for Puerto Rico, compared to what they are currently receiving in fiscal year 2021. As you can imagine this puts Medicaid programs and services on the chopping block and puts the care that CYSHCN and families need in those territories in the frying pan! The Health Subcommittee of the House Energy and Commerce Committee considered the Supporting Medicaid in the U.S. Territories Act of 2021 (H.R. 4406) bill during committee markup last week and there is reported bipartisan support to avert the fiscal cliff. 
Heated: Closing the Medicaid Coverage Gap
The Medicaid Saves Lives Act, introduced by U.S. Senators Reverend Raphael Warnock (D-GA), Tammy Baldwin (D-WI), and Jon Ossoff (D-GA), would create a federal Medicaid-style program for those living in Medicaid non-expansion states. Among other things, this bill creates a federal Medicaid look-alike program that is run and administered by the Centers for Medicare and Medicaid Services (CMS) and would provide the same full benefits as Medicaid. Fueled by the belief that access to Medicaid should not be dependent on where you live, there is data indicating that closing the Medicaid gap could narrow disparities and save the federal government millions.
Warming up to go back to school
Back to school guidance and plans
Earlier this month, the CDC updated their guidance for school systems planning return to in-person learning in the fall. This weekend, the AAP issued updated school guidance that amplified all of the CDC recommendations, but took a stronger stance than the CDC on universal masking. Specifically, the AAP recommends children return to in-person learning in the fall and all students above the age of 2 and school staff wear a mask, unless they have medical conditions that prevent them from doing so. The main reason for the guidance is the fact all children under the age of 12 are not yet eligible for vaccination, so the universal mask recommendation would keep the Covid-19 virus, along with other respiratory viruses, from spreading and preventing children from attending class. The CDC has recommended less stringent mask guidance for the 2021-2022 school year, allowing students and staff to not have to wear masks indoors if they are vaccinated and allowing everyone to go mask free outdoors.
States Enact Laws to Address School Vaccine Mandates
As states prepare for a return to in-person learning, an increasing number are enacting laws to prohibit mandates for COVID-19 vaccinations as a condition of school attendance. This newly expanded NASHP tracker shows state legislation that has been introduced, passed by the legislature, or signed by the Governor that would prohibit or make optional requirements for students to be vaccinated against

Another NASHP TRACKER: Updated for 2021 States' Public Health Emergency Declarations, Mask Requirements, and Travel Advisories. Locate your specific state or get a sense of other states across the country.
Hot opportunities
Respite Provider Training and Recruitment Pilot
The ARCH National Respite Network and Resource Center and the Respite Care Association of Wisconsin, in collaboration with the National Academy for State Health Policy (NASHP) are seeking applicants to participate in a pilot project to field test a competency-based and enhanced entry-level respite provider training curriculum and recruitment campaign. The purpose of the initiative is to develop, test, and scale a respite workforce recruitment, training, and retention program to better meet the respite needs of families, particularly in light of the impact of the COVID-19 pandemic on the workforce. Eligible applicants include State Respite and/or Caregiver Coalitions, governmental agencies, academic institutions, regional (multi-county) or statewide non-profit organizations. Applicants who can demonstrate a statewide reach will be given priority. Up to six sites will be selected and funding is available. Only one site per state will be selected. Applications are due August 6, 2021, and more information including the application can be found here.

HHS Request for Information: Best Practices for Advancing Cultural Competency, Language Access and Sensitivity toward Asian Americans and Pacific Islanders
The U.S. Department of Health and Human Services (HHS) Office of Minority Health (OMH) are seeking input from Asian American and Pacific Islander (AAPI) communities and AAPI-serving organizations to inform the development of guidance describing best practices for advancing cultural competency, language access, and sensitivity toward Asian Americans and Pacific Islanders in the context of the Federal Government's COVID-19 response. This is NOT a solicitation for proposals or proposal abstracts. Written comments must be submitted and received at the address provided below, no later than 11:59 p.m. on August 17, 2021. Access the request for information here.

Preferred method: Submit information through the Federal eRulemaking Portal at http://www.regulations.gov. Follow the online instructions for submissions.

Email: Send comments to minorityhealth@hhs.gov with the subject line “OMH RFI: AAPI Best Practices.”

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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.