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Washington DC Update 10/21/2020
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September is National Suicide Prevention Awareness Month. 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
In this Update:

  • The prospects for legislation to address the pandemic’s financial impact are very dim. 

  • The Senate is expected to vote on Monday to confirm Judge Amy Coney Barrett to the Supreme Court.  

  • The Maternal and Child Health Bureau is seeking comments on a draft “Blueprint for Change: Guiding Principles for Advancing the System of Services for Children and Youth with Special Health Care Needs (CYSHCN) and Families.” (See “Your Input Sought” section, near the end of this Update.)

  • The deadline has been extended until November 18 for comments on a Recommended Measure Set for Medicaid-Funded Home and Community-Based Services. 

  • The deadline for people who do not file tax returns to submit information to the IRS in order to get their stimulus checks this year has been extended until November 21.

ECONOMIC IMPACT PAYMENTS (stimulus checks) -- DEADLINE EXTENDED: Individuals who are eligible for but have not yet received an a stimulus check must provide information to the IRS by November 21 at Midnight ET to get the checks this year.

To help families get their payments, see Helping Consumers Claim the Economic Impact Payment: A guide for intermediary organizations, prepared by the Consumer Financial Protection Bureau, which also has information for consumers about managing finances during the pandemic. 

Open Enrollment Period
The next Open-Enrollment Period begins on Sunday, November 1, and runs through Tuesday, December 15, 2020. Coverage begins January 1, 2021.

If someone doesn’t enroll in a plan by December 15, they can’t get 2021 coverage unless they qualify for a Special Enrollment Period. Visit HealthCare.gov

For a refresher on coverage and benefits, see the September 10 blog post on Healthcare.gov, Marketplace health benefits & coverage: What to know.

Steps to Take When Trick or Treating (from the Centers for Disease Control and Prevention)

October is Health Literacy Month
For ideas about events or activities, and other resources, see the Share and Interact page of the CDC Health Literacy website. 

  • Congress
  • Medicaid & Chip
  • Telehealth
  • Vaccines
  • Affordable Care Act
  • Other News, Information and Resources
  • TRICARE and Military Health System (COVID and non-COVID issues)
  • Your Input Sought
  • Upcoming Webinars and Calls
  • Of Possible Interest
Economic Relief Legislation
As of this writing (Tuesday afternoon), it looks unlikely that the three necessary parties – the House, Senate, and White House -- will be able to agree on another COVID financial-relief bill before the election. House Speaker Nancy Pelosi (D-CA) and Treasury Secretary Steven Mnuchin have been negotiating for weeks, and, after sending mixed signals last week, the president has said he would like to “go big.”

Given the limited amount of time before Congress goes on recess to campaign, Speaker Pelosi said that a deal with the White House would have to be reached by the end of the day on Tuesday to be enacted before the election. Even if the House and White House can reach a timely deal, however, it is unlikely the Senate would go along. In September, that chamber took up, but failed to pass a “skinny” bill that would have provided far less than half the amount of aid under consideration by Pelosi and Mnuchin.

The Senate is scheduled to vote on similar legislation this week but, again, it is not expected to pass. (Republicans think it is too costly; Democrats think it does not provide sufficient relief, particularly to states and localities.) Depending on the outcome of the election, another COVID-relief package might not be taken up until January or February, if then. Sources: Trump tells Fox he wants bigger relief deal as Pelosi's deadline nears (The Hill, 10/20/20, 09:28 AM EDT); Senate Republicans cringe at Trump's stimulus negotiations (Politico, 10/19/20, 07:45 PM EDT) One more day for coronavirus relief talks, Pelosi says (Roll Call, 10/19/20, 6:15 pm). Senate Republicans could be the real roadblock to getting a stimulus deal passed (Vox, 10/19/20).

Votes on Supreme Court Nominee
The Senate Judiciary Committee is scheduled to meet at 9:00 AM ET on Thursday, October 22, to vote on the nomination of Amy Coney Barrett to become an Associate Justice on the Supreme Court. Notwithstanding Democratic opposition, it is expected that the committee and the full Senate will vote to approve her nomination. The full Senate is expected to vote on Monday, October 26, after a procedural vote on Sunday. See Senate GOP eyes Oct. 26 for confirming Barrett to Supreme Court (The Hill, 10/19/20). 
Medicaid & CHIP
Deadline Extended to Nov. 18 for Request for Information about Medicaid HCBS Quality Measures (See “Your Input Sought,” below.)

Many health advocacy groups oppose these Medicaid and ACA waivers. The Medicaid waiver will allow the state to impose premiums and work requirements on the new (adult) population of Medicaid beneficiaries that the state will cover. In addition, the administration is expected to approve a waiver authorized under the Affordable Care Act (ACA). Under that waiver, the state would stop using the website HealthCare.gov but not set up its own exchange. Instead consumers would have to purchase ACA-subsidized insurance solely from private agents and brokers. These agents and brokers may have financial incentives to could steer people with pre-existing conditions to sub-standard plans, and they do not have the incentive or means to determine whether someone might qualify for Medicaid. See Federal Action Jeopardizes Healthcare Coverage for Patients in Georgia (multi-organization press release, 10/15/20).

This new report from the National Alliance to Advance Adolescent Health/Got Transition®, offers options that states can use or adapt to improve the availability of transition services for youth and families. A webinar on Friday, November 13, will offer more information. (See “Webinars” section, below.)
New CMS Supplement to State Medicaid and CHIP Telehealth Toolkit
As explained in an October 14, 2020 press release, the Centers for Medicare and Medicaid Services (CMS) released a new supplement to its earlier State Medicaid & CHIP Telehealth Toolkit: Policy Considerations for States Expanding Use of Telehealth, COVID-19 Version. The supplement updates and consolidates the Frequently Asked Questions (FAQs) and resources states can use in planning beyond the temporary telehealth flexibilities tied to the Public Health Emergency. At the same time, CMS also released a preliminary Medicaid and CHIP data snapshot on telehealth utilization during the Public Health Emergency. This snapshot shows that there have been more than 34.5 million services delivered via telehealth to Medicaid and CHIP beneficiaries between March and June of 2020, an increase of more than 2,600% from the same period last year. Adults ages 19-64 received the most services delivered via telehealth, although there was substantial variance across both age groups and states. CMS also announced additions to the telehealth benefits that Medicare will cover on a fee-for-service basis.

Family Voices Survey on Telehealth
As health care providers ramp up the use of telemedicine, Family Voices is interested in improving families’ access to and use of telehealth. They are asking families to complete a survey describing their access to telehealth, and their confidence in and concerns about virtual services. Take the anonymous survey in English or Español.

Transition after Public Health Emergency Ends:
Policy analysts are starting to think about how states will transition back to “normal” when special rules for the federal Public Health Emergency expire. See:

New Guidelines on Nursing Home Visitation
On September 17, the CMS Center for Clinical Standards and Quality/Survey & Certification Group issued new guidance to State Survey Agency Directors, Nursing Home Visitation - COVID-19.
In a new video, Dr. Anthony Fauci, Dr. Moncef Slaoui, and other HHS experts explain how vaccines are safe, effective, and have saved millions of lives, and how science and ingenuity are informing the development of COVID-19 vaccines.

(National Academy for State Health Policy, 10/12/20)
Affordable Care Act
Georgia ACA Waiver
The administration is expected to grant the state of Georgia a waiver under section 1332 of the Affordable Care Act. 
Please see the “Medicaid” section above for more detail.

What’s New for 2021 Marketplace Enrollment? (CHIRblog, Georgetown Center for Health Insurance Reforms, 10/19/20)

What’s at Stake: The World of Health Insurance for People with Pre-Existing Conditions before the ACA (CHIRblog, Georgetown Center on Health Insurance Reforms, 10/13/20)
Other News, Information, and Resources
In the fall of 2019, the Maternal and Child Health Bureau (MCHB) began working with a small group of CYSHCN experts and families to reexamine systems of care for CYSHCN and to identify priorities and opportunities that can advance those systems and improve outcomes. The result is a draft Blueprint that can inform programs and policy at the community, state, and federal levels in four key areas:   
  • Health Equity 
  • Access to Services and Supports 
  • Family/Child Well-being and Quality of Life 
  • Financing of Services 

MCHB invites public comments on the draft Blueprint and how this work can be operationalized at the community, state and federal levels. Please submit comments via email to [email protected] and reference "CYSHCN Blueprint RFI" in the subject line.
The deadline to respond is Monday, November 30, 2020, by 11:59 p.m. Eastern Time.
Please share widely.

The Social Security Administration (SSA) has announced a 1.3 percent cost-of-living adjustment (COLA) for Social Security and Supplemental Security Income (SSI) benefits in 2021. The SSI Federal Payment Standard will increase from $783 per month in 2020 to $794 per month in 2021. See this fact sheet for details.

On October 15, the American Academy of Pediatrics released its latest Blueprint for Children, which outlines a comprehensive child health policy agenda for 2020 and beyond.

First Focus on Children has released its 14th annual Children’s Budget publication. This year’s report details the persistence of an alarming trend: children continue to receive a smaller and smaller share of federal spending.

From Family Voices: New Tool on Shared Decision Making! 
The American Academy of Pediatrics (AAP) interim guidance, Caring for Children and Youth With Special Health Care Needs During the COVID-19 Pandemic, highlighted the importance of Shared Decision Making (SDM) between families and providers in navigating COVID-19. Family Voices has created the SDM Tool for families, which provides more information about this concept, and some examples of how parents can initiate conversations with their child’s care team. (Please share with your networks via email or social media posts, and let us know how you have used this tool with your children or families you work with.)

The HHS Centers for Disease Control and Prevention (CDC) have released guidance on Pregnancy, Breastfeeding and Caring for Newborns during the COVID-19 pandemic.
TRICARE and Military Health System
2020 TRICARE Open Season is November 9 to December 14, 2020.

TRICARE Young Adult (TYA) is available for purchase by certain family members under the age of 26 who have lost or will lose TRICARE eligibility due to age. Qualified adult children can purchase TYA coverage after regular TRICARE coverage ends at: 
  • Age 21
  • Age 23 (if enrolled in college full time or at a college graduation, whichever comes first)
See the TRICARE Young Adult Program Fact Sheet to learn more about who qualifies for TYA and how to purchase TYA coverage. [TRICARE wants to hear your feedback. Take the publications survey, and share your thoughts about this publication.]

For other TRICARE news and information, see the TRICARE Benefits Updates and TRICARE Publications.

To keep up with TRICARE and COVID-19 updates, sign up for email alerts.
Download the latest TRICARE East Region or TRICARE West Region newsletter at www.tricare.mil/publications.
See “Medicaid” section above about the Request for Information about Medicaid HCBS Measures.
September 15 through October 22, 2:00 ET
Health Reform: Beyond the Basics (Center for Budget and Policy Priorities) 
All webinars will be recorded and available for viewing on the Center’s website.

October 21, 1:00-2:30 ET
Trust for America’s Health

October 21, 2:00-3:00 ET
National Academy for State Health Policy

October 21, 2:00-3:30 ET
Health Affairs 

October 27, 1:00 ET
National Alliance to Advance Adolescent Health/Got Transition®

October 27, 3:00 ET
Manatt Health, the American Academy of Pediatrics, Family Voices and the Georgetown University Center for Children and Families

October 28, 2:00 ET
Centers for Medicare and Medicaid Services
Review the recordings from the last two installments of the MFP-TI series:
·      MFP-TI, Part 1 – Tribes in Washington
·      MFP-TI, Part 2 – Tribes in North Dakota & South Dakota
Have questions for our presenters?
Let us know before the webinar by emailing [email protected].

October 29, 1:00-2:00 ET
Health and Human Services Assistant Secretary for Preparedness and Response
Earlier webinars in this series:

October 29, 1:00-2:00 ET
TRICARE/Military One Source

October 29, 2:00-3:00 ET
Centers for Medicare and Medicaid Services (CMS)

November 9, 2:00 ET
Family Voices of California

November 18 - November 19, 2020
The Health Resources and Services Administration, Office of Regional Operations - Regions 6, 7, and 8, Heartland, Southwest, and the Great Plains Telehealth Resource Centers, North Dakota Department of Health, and the Spirit Lake Tribe

*There is no registration fee.*
For more information, contact Lilia Salazar at 214-767-3073 or at [email protected] 

November 19, 2:00 ET
Alliance for Justice

American Red Cross
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Thank you for subscribing to the Washington DC Update newsletter. Please feel free to contact Family Voices Policy Director, Janis Guerney, 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 "SafeUnsubscribe" 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.