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Washington DC Update 3/9/22
It wouldn’t be a week in Washington if a deadline with a fiscal cliff wasn’t looming!

As both chambers of Congress kick off the March legislative work session this week there is likely to be a lot of roaring as they deal with a March 11 government funding deadline, a lengthy list of legislative priorities, Supreme Court confirmation hearings, and crisis in Ukraine. 

Government Funding
Congressional appropriations leaders are racing to finalize the fiscal year (FY) 2022 omnibus spending deal prior to expiration of the continuing resolution at midnight March 11. Reports indicate that the 12-bill spending package is nearly final, but it remains to be seen how lawmakers will address the White House's supplemental funding request to support Ukraine and pandemic response efforts. As of now, House lawmakers are hoping to vote on the package on March 9…and also vote on an extension of the continuing resolution to March 15. As it stands now, there is likely not enough time for the Senate to go through all of its processes prior to the March 11 midnight deadline.

Supreme Court Nominee
In February, Senate and House Committees held a number of hearings on behavioral health, including two Senate Finance Committee hearings on youth mental health (part 1 and part 2), a Senate HELP Committee hearing on mental health and substance use, a House Energy and Commerce Committee hearing on mental health, and two House Ways and Means Committee hearings on the mental health crisis and substance use and suicide. Senate Finance and Senate HELP committees both expect to put forth broad bipartisan packages addressing the mental/behavioral health crisis this summer.
From the Administration
CMS Guidance: Navigating Coverage Determinations after the Public Health Emergency
The Centers for Medicare and Medicaid Services (CMS) released a letter to state health officials aimed at assisting states in streamlining coverage determinations for federal programs after the conclusion of the public health emergency (PHE). The guidance builds on previously issued guidance and is intended, according to CMS, to ensure that individuals continue to have health coverage.  

  • CMS concurrently released a PHE Unwinding toolkit and refreshed its slide deck highlighting Managed Care Organizations’ role in supporting states and Medicaid beneficiaries during the “PHE Unwinding period.” 
  • The document stresses that the release of this guidance does not presuppose a specific time frame for when the PHE will occur. Rather, it is designed to help states plan.

White House: National COVID-19 Preparedness Plan
Found HERE, the plan laid out by the White House is organized in 4 sections: prevent against and treat COVID-19, prepare for new variants, prevent economic and educational shutdowns, and continue to vaccinate the world.
NOTE: Although the future of many of the provisions outlined in Build Back Better are unknown, it is interesting to find paid sick leave to workers who need to miss work due to a case of COVID-19 or to care for a loved one with COVID-19. Although not fully responsive to the proposals for comprehensive Paid Family Leave, the Administration notes that they “will work with Congress to reinstate tax credits to help small- and mid-size businesses provide paid sick and family leave to deal with COVID-related absences.”

White House Fact Sheet: Mental Health Crisis Agenda
As part of the “Unity Agenda” (consists of historically bipartisan policies) proposed by President Biden in his recent State of the Union address, this fact sheet outlines an agenda to address the national mental health crisis.

Of particular interest to family-led organizations, are two strategies outlined in the fact sheet:

  • Pilot new approaches to train a diverse group of paraprofessionals. Doctors, nurses, and other clinicians cannot do this work alone. In the fall of 2022, HHS expects to award over $225 million in training programs to increase the number of community health workers and other health support workers providing services, including behavioral health support, in underserved communities. The President’s FY23 budget will also propose major new multi-year funding to develop provider capacity and support mental health transformation. 
  • Build a national certification program for peer specialists.  The Biden-Harris Administration will convene stakeholders, launch development, and support implementation of a national certified peer specialist certification program, which will accelerate universal adoption, recognition, and integration of the peer mental health workforce across all elements of the health care system.

Impact of Climate Change on Mental and Physical Health
Did you know that the U.S. Department of Health and Human Services (HHS) has a new Office of Climate Change and Health Equity (OCCHE)? Led by Admiral Rachel Levine, OCCHE focuses on addressing the impact of climate change on the health of all Americans.

The Intergovernmental Panel on Climate Change recently released a report Climate Change 2022: Impacts, Adaptations and Vulnerability Summary for Policymakers. “This report makes it clear that the choices we make now will determine the future of our health and the health of the world; highlighting both the mental and physical health effects of climate change, which are often overlooked,” said Admiral Rachel Levine, Assistant Secretary for Health at HHS. “This report confirms that those who lack proper infrastructure and basic health services suffer most from changing climatic conditions. HHS is committed to using every tool available to protect the health of our nation from the devastating effects of climate change.” 

Worth repeating: CMS Issues RFI on Promoting Access to Care and Coverage in Medicaid and CHIP
On February 17, CMS issued a Request for Information (RFI) on strategies to promote access to care and coverage in Medicaid and CHIP; responses will be used to inform a comprehensive access strategy. The questions include a focus on ensuring coverage during the public health emergency unwinding, monitoring access in both fee-for-service and managed care delivery systems, enhancing reimbursement rates, and developing minimum access standards. CMS is accepting responses through April 18, 2022
Blog Posts/Briefs/Reports of Interest
Blog Post: Consumer Advocate Perspectives on CMS’s 2023 Notice of Benefit Payment Parameters
On January 5, 2022, the Centers for Medicare & Medicaid Services (CMS) released its annual proposed rule governing the Affordable Care Act (ACA) health insurance marketplaces and insurance standards for 2023. The rule reverses several provisions instituted by the previous administration and proposes several new requirements. Comments on the proposed rule were due by January 27, 2022.

The Georgetown Center on Health Insurance Reforms team reviewed a selection of stakeholder comments (from organizations such as Community Catalyst and NHeLP) submitted in response to the proposed rule and summarize key takeaways HERE.

Policy Brief: Medicaid and Youth Mental Health
The National Association of Medicaid Director’s Federal Policy Briefs: Behavioral Health series to learn more about how Medicaid can drive transformations in our systems of care for mental health and substance use. Our third brief highlights the need for urgent action to address the youth mental health crisis, and federal policy opportunities to improve the behavioral healthcare system for children and young people.  You can also find the Medicaid Forward: Behavioral Health report HERE.

Updated Report: Leveraging Federal and State Authorities for LTSS
Since the start of the COVID-19 pandemic, federal and state policymakers have acted to preserve access to services for populations that use Medicaid-covered long-term services and supports (LTSS). Manatt Health described these actions in “COVID-19 State Resource Guide: Leveraging Federal and State Authorities to Ensure Access to Long-Term Services and Supports for High-Risk Individuals,” published in February 2021. Manatt has updated the resource guide based on a scan of new or modified regulatory flexibilities and other state administrative actions through July 2021, as well as on continued monitoring of states’ overall responses to the pandemic to ensure access to LTSS for high-risk individuals. Click here to access a free copy of the full update.
Issue Briefs: Kaiser Family Foundation tracks HCBS

State Policy Choices about Medicaid Home and Community Based Services organizes policy choices in four areas: whom to cover, what to cover, how to deliver services, and how to reimburse providers.

Access Brief: Experiences in Accessing Medical Care by Race and Ethnicity
The Medicaid and Chip Payment and Access Commission recently released an issue brief on Experiences in Accessing Medical Care by Race and Ethnicity. The brief uses data from the 2015-2018 National Health Interview Survey (NHIS) to assess Medicaid members’ access to care by race and ethnicity. Notably, the study found that Black, Hispanic, and Asian Medicaid members had significantly lower rates of receiving some preventive health screenings as compared to white non-Hispanic members and that Black and Hispanic Medicaid members were less likely than white non-Hispanic members to receive primary care and mental health care visits.

State Strategies to Recover Routine Immunizations Rates
This NASHP paper outlines strategies states may consider to improve routine childhood vaccination rates and catch up the millions of children who are behind on vaccinations due to the challenges posed by the pandemic. New strategies are needed to identify and catch up children who have missed routine immunizations to prevent future outbreaks of vaccine-preventable diseases.
Webinars of Interest
Webinar: Discussion with States on Medicaid Unwinding
Friday, March 11, 2022, 2-3 pm EST
Hosted by NASHP (National Academy for State Health Policy), this webinar will feature three state officials each representing a different public coverage program — Medicaid, CHIP, and a state-based marketplace — to share their unique perspectives on their current efforts and the challenges of planning in the context of continued uncertainty. 
Archived Webinar: State Policies to Strengthen the Direct Care Workforce
Funded by The John A. Hartford Foundation and the RRF Foundation for Aging, NASHP’s RAISE Family Caregiver Resource and Dissemination Center hosted this webinar to discuss state policies to improve the quality and supply of the direct care workforce, which are featured in the newest section of its RAISE State Policy Roadmap for Family Caregivers. The webinar provided an overview of state policies and featured a national leader as well as leaders from Arizona and Colorado who shared their policies and innovations to strengthen the home and community-based services workforce. 
In case you missed it: Disability Policy Seminar
2022 Disability Policy Seminar
March 28-30, 2022 | A Hybrid Event
In person at the Renaissance Downtown Hotel
Washington, DC
The Disability Policy Seminar, hosted by multiple national disability organizations, will showcase the many avenues that advocates could take to engage with their members of Congress. From online meetings to in-person actions, the Day of Action will prepare you with an assortment of tools to choose from when you advocate for issues that matter to you at the local, state, or federal level. Attendees will learn about the latest in:

  • Community living and funding for home and community-based services
  • Voting rights, access, and education
  • What to expect from Congress and the Administration in 2022
  • Social Security improvement opportunities
  • Criminal justice reform

Thank you for subscribing to the Washington DC Update newsletter. Please feel free to contact the Family Voices Director of Public Policy and Advocacy, Cara Coleman, with any questions. Past issues of the Update appear on the Family Voices website. If you wish to unsubscribe, you can do so via the "Unsubscribe" link below.

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.